Summary
Thiamine in acute alcohol poisoning
Affiliation of the authors
DOI
Quote
Supervía A, Fortea R, Palomino A, Anaya S, Aranda MD, Pallàs O. Thiamine in acute alcohol poisoning. Rev Esp Urg Emerg. 2023;2:147–50
Summary
BACKGROUND AND OBJECTIVE. Thiamine is indicated for treating and preventing Wernicke encephalopathy and should be administered in cases of chronic alcoholism or malnutrition. This study evaluated whether thiamine is used appropriately in patients with acute alcohol poisoning.
MATERIAL AND METHODS. Retrospective study of all patients treated for acute alcohol poisoning in a university hospital emergency department in 2021. We collected patient characteristics, means of transport to the hospital, psychiatric history, prior history of alcohol poisoning, clinical characteristics, and concomitant use of other toxic substances. Cases were distributed into 2 groups (thiamine vs no thiamine administered) for analysis of whether the use was indicated or not. We also explored differences in characteristics between the groups.
RESULTS. A total of 341 patients were treated for acute alcohol poisoning. Thiamine was administered in 98 cases (28.7%) and was correctly indicated in 78 (79.6%). Thiamine-group patients were older on average (mean [SD] age, 42.9 [13.6] years vs 34.1 [15.3] years in the no-thiamine group, P < .001) and more were men (36.6%) than in the no-thiamine group (15.2%) (P < .001). A score of less than 9 on the Glasgow Coma Scale was more common in the thiamine group (52.9% vs 26.8% in the no-thiamine group; P = .027). Other characteristics that were more common in patients treated with thiamine were a history of prior alcohol poisoning (79.6% vs 44%, P < .001) and psychiatric events (29.6% vs 18.5%; P = .025).
CONCLUSIONS. Thiamine is administered in more than a quarter of patients treated for acute alcohol poisoning. Its use is usually indicated. Older age, male sex, a history of psychiatric events, and prior alcohol poisoning are associated with administering thiamine.