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When Studies Say Yes, But Doctors Say No

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A new observational study of AUD patients admitted to intensive care units across the US found that over half did not receive thiamine (vitamin B1) therapy.

Nearly half of patients with alcohol use disorder (AUD) hospitalized to intensive care units across the United States did not receive thiamine (commonly known as vitamin B1) therapy, according to an observational study published today.

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.

Thiamine deficiency can result in various life-threatening conditions, including the Wernicke–Korsakoff syndrome, a degenerative brain ailment.

Thiamine deficiency, if left untreated, can result in death or irreparable brain damage. It is well established that patients with AUD are at a greater risk of developing thiamine deficient problems, and current guidelines advocate supplementing in this population.

Despite the fact that guidelines indicate thiamine supplementation for patients with AUD, there is limited data on how patients are managed in the critical care situation by clinicians.

The Beth Israel Deaconess Medical Center researchers examined the health records of nearly 15,000 patients with AUD and a wide range of critical illnesses, including alcohol withdrawal, septic shock, traumatic brain injury (TBI), and diabetic ketoacidosis (DKA), to determine how frequently thiamine supplementation was administered.

The researchers discovered that less than half of patients with AUD received thiamine treatment on average. Those presenting with alcohol withdrawal were more likely to get thiamine (59%) than those presenting with TBI (41%), septic shock (26%), or DKA (24%).

According to the researchers, these data underscore the importance of raising awareness about the need for thiamine supplementation, particularly among patients with AUD who are hospitalized to the intensive care unit (ICU) with sepsis or another kind of critical illness.

Additionally, they indicate that these data point to an area for quality improvement.

Source: doi/10.7326/M21-2103 – Annals of Internal Medicine

Image Credit: Getty

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