일 대학병원에 입원하는 알코올 의존 환자에서 동반되는 베르니케 뇌병증의 선별 및 치료
Screening and Treating Wernicke’s Encephalopathy among Alcoholic Patients in a University Hospital
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objectives The purpose of this study was to investigate the prevalence and clinical characteristics of Wernicke’s encephalopathy (WE) patients in alcoholics and to evaluate the utility of Caine’s criteria as a screening test. Methods We made an admission note including Caine’s criteria and applied it to patients who were admitted to an alcohol treatment unit. Demographic, clinical, and laboratory data were collected on 204 alcoholics. Our alcoholics who met more than one of Caine’s criteria were considered at risk for WE and were given high-dose thiamine IV therapy. Results WE was diagnosed in 15.2% of the alcoholic patients. Age and head trauma history were risk factors of WE. The sensitivity of Caine’s criteria was 97% and specificity was 54%. High-dose thiamine IV therapy appeared to be a safe and cost-effective method to prevent the serious complications of WE. Conclusion Caine’s criteria is useful as a screening test for WE among alcoholic patients. High-dose thiamine IV therapy is cost-effective for alcoholic patients who are considered to be at risk for WE.
Abstract
Objectives The purpose of this study was to investigate the prevalence and clinical characteristics of Wernicke’s encephalopathy (WE) patients in alcoholics and to evaluate the utility of Caine’s criteria as a screening test. Methods We made an admission note including Caine’s criteria and applied it to patients who were admitted to an alcohol treatment unit. Demographic, clinical, and laboratory data were collected on 204 alcoholics. Our alcoholics who met more than one of Caine’s criteria were considered at risk for WE and were given high-dose thiamine IV therapy. Results WE was diagnosed in 15.2% of the alcoholic patients. Age and head trauma history were risk factors of WE. The sensitivity of Caine’s criteria was 97% and specificity was 54%. High-dose thiamine IV therapy appeared to be a safe and cost-effective method to prevent the serious complications of WE. Conclusion Caine’s criteria is useful as a screening test for WE among alcoholic patients. High-dose thiamine IV therapy is cost-effective for alcoholic patients who are considered to be at risk for WE.
참고문헌 (18)
- Sechi G, "Wernicke’s encephalopathy: new clinical settings and recent advances in diagnosis and management", Lancet Neurol, 6, pp.442~455 (2007)
- Thomson AD, "Wernicke’s encephalopathy: Plus ça change, plus c est la mème chose", Alcohol Alcohol, 43, pp.180~186 (2008)
- Thomson AD, "The natural history and pathophysiology of Wernicke’s Encephalopathy and Korsakoff’s Psychosis", Alcohol Alcohol, 41, pp.151~158 (2006)
- Sgouros X, "Evaluation of a clinical screening instrument to identify states of thiamine deficiency in inpatients with severe alcohol dependence syndrome", Alcohol Alcohol, 39, pp.227~232 (2004)
- 박우영, "췌십이지장절제술 후 발생한 지속적인 구토증과 Wernicke 뇌병증", 신경정신의학, 46(3), pp.267~270 (2007), 대한신경정신의학회
- Harper CG, "Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy", J Neurol Neurosurg Psychiatry, 49, pp.341~345 (1986)
- Naidoo DP, "Wernicke’s encephalopathy and alcohol-related disease", Postgrad Med J, 67, pp.978~981 (1991)
- Sullivan EV, "Neuroimaging of the Wernicke-Korsakoff syndrome", Alcohol Alcohol, 44, pp.155~165 (2009)
- Kim E, "Mammillothalamic functional connectivity and memory function in Wernicke's encephalopathy", Brain, 132(2), pp.369~376 (2009)
- "Restoration of mammillothalamic functional connectivity through thiamine replacement therapy in Wernicke's encephalopathy", Neuroscience Letters, 479(3), pp.257~261 (2010), ELSEVIER IRELAND LTD
- Mancinelli R, "Simultaneous liquid chromatographic assessment of thiamine, thiamine monophosphate and thiamine diphosphate in human erythrocytes: a study on alcoholics", J Chromatogr B Analyt Technol Biomed Life Sci, 789, pp.355~363 (2003)
- Thomson AD, "Royal College of Physicians, London. The Royal College of Physicians report on alcohol: guidelines for managing Wernicke’s encephalopathy in the accident and Emergency Department", Alcohol Alcohol, 37, pp.513~521 (2002)
- Caine D, "Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy", J Neurol Neurosurg Psychiatry, 62, pp.51~60 (1997)
- Pitel AL, "Signs of preclinical Wernicke’s encephalopathy and thiamine levels as predictors of neuropsychological deficits in alcoholism without Korsakoff’s syndrome", Neuropsychopharmacology, 36, pp.580~588 (2011)
- Antunez E, "Usefulness of CT and MR imaging in the diagnosis of acute Wernicke’s encephalopathy", AJR Am J Roentgenol, 171, pp.1131~1137 (1998)
- Pitkin SR, "Age-related vulnerability to diencephalic amnesia produced by thiamine deficiency: the role of time of insult", Behav Brain Res, 148, pp.93~105 (2004)
- Brion S, "Post-traumatic Korsakoff’s syndrome: clinical and anatomical report", Encephale, 27, pp.513~525 (2001)
- Bagby RM, "The Hamilton Depression Rating Scale: has the gold standard become a lead weight", Am J Psychiatry, 161, pp.2163~2177 (2004)