Only About Half of Patients With Alcohol Use Disorder Who Are Admitted to ICU Receive Thiamine

December 7, 2021

An observational study of patients with alcohol use disorder (AUD) admitted to intensive care units throughout the United States found that almost half of the people evaluated did not receive thiamine supplementation.

Patients with AUD who were admitted for reasons other than alcohol withdrawal had both a numerically lower incidence and lower predicted probability of receiving thiamine than those admitted for alcohol withdrawal.

The findings are published in Annals of Internal Medicine.

Thiamine deficiency can cause several life-threatening disorders, including Wernicke-Korsakoff syndrome. Left untreated, thiamine deficiency can result in death or potentially irreversible neurological damage. Patients with AUD are known to have an increased risk for thiamine deficiency disorders and current guidelines recommend supplementation in this population. However, despite guidelines recommending thiamine supplementation for patients with AUD, limited data exists regarding how patients are treated by clinicians in the critical care setting.

Rahul D. Pawar, MD, Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues studied health records for nearly 15,000 patients with AUD and various critical illnesses, including alcohol withdrawal, septic shock, traumatic brain injury (TBI), and diabetic ketoacidosis (DKA) to describe how often thiamine supplementation was provided.

The researchers found that overall, only about half of patients with AUD received thiamine supplementation. Those who presented with alcohol withdrawal were more likely to receive thiamine (59%) than those with TBI (41%), septic shock (26%), and DKA (24%).

“Thiamine supplementation was not provided to almost half of all patients with AUD, raising a quality-of-care issue for this cohort,” the authors wrote.

According to the researchers, these findings highlight a need for increased awareness of the need for thiamine supplementation, especially for patients with AUD who are admitted to the ICU with sepsis and other forms of critical illness. They further suggest that these findings reveal a potential area for quality improvement.

Reference: https://www.acpjournals.org/doi/10.7326/M21-2103

SOURCE: American College of Physicians