Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy:: A Multicenter Observational Study

R Muga-Bustamante; AJ Chamorro; B Rosón-Hernández; JA Medina-García; J Fernández-Solá; MC Martín-González; E Seco-Hernández; I Novo-Veleiro; C Suárez-Cuervo; AM Mateos-Díaz; R Monte-Secades; B Machado-Prieto; R Puerta-Louro; C Prada-González; A Fernández-Rial; P Sabio-Repiso; R Vázquez-Vigo; AC Antolí-Royo; A Gomila-Grange; NC Felipe-Pérez; A Sanvisens-Bergé; E Antúnez-Jorge; CM Fernández-Rodríguez; L Alvela-Suárez; A Fidalgo-Navarro; Miguel Marcos; Wernicke-SEMI Group; Alcohol and Alcoholism Group; Society of Internal Medicine (SEMI) Spanish

doi:10.1016/j.mayocp.2017.02.019

Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy: A Multicenter Observational Study

R Muga-Bustamante, AJ Chamorro, B Rosón-Hernández, JA Medina-García, J Fernández-Solá, MC Martín-González, E Seco-Hernández, I Novo-Veleiro, C Suárez-Cuervo, AM Mateos-Díaz, R Monte-Secades, B Machado-Prieto, R Puerta-Louro, C Prada-González, A Fernández-Rial, P Sabio-Repiso, R Vázquez-Vigo, AC Antolí-Royo, A Gomila-Grange, NC Felipe-PérezA Sanvisens-Bergé, E Antúnez-Jorge, CM Fernández-Rodríguez, L Alvela-Suárez, A Fidalgo-Navarro, Miguel Marcos, Wernicke-SEMI Group, Alcohol and Alcoholism Group, Society of Internal Medicine (SEMI) Spanish

Departamento de Medicina

Instituto de Investigación e Innovación Parc Taulí (I3PT)

Producción científica: Contribución a una revista › Artículo › Investigación › revisión exhaustiva

50 Citas (Scopus)

Resumen

Objective
To analyze the differences in characteristics and prognosis between alcoholic and nonalcoholic patients with Wernicke encephalopathy (WE).
Patients and Methods
A retrospective observational cohort of 468 patients diagnosed with WE with at least 2 Caine criteria was selected from all patients discharged with a diagnosis of WE from 21 medical centers in Spain from January 1, 2000, through December 31, 2012. Demographic, clinical, and outcome variables were described.
Results
Among the 468 patients, the most common risk factor was alcoholism (n=434 [92.7%]). More than one-third of patients (n=181 [38.7%]) had the classic WE triad of symptoms (ocular signs, cerebellar dysfunction, and confusion). Among 252 patients for whom magnetic resonance imaging data were available, 135 (53.6%) had WE-related lesions and 42 (16.7%) had cerebellar lesions. Of the 468 patients, 25 (5.3%) died during hospitalization. Alcoholic patients presented more frequently than nonalcoholic patients with cerebellar signs (P=.01) but less frequently with ocular signs (P=.02). Alcoholic patients had a significantly higher frequency of hyponatremia (P=.04) and decreased platelet count (P=.005) compared with nonalcoholics. Alcoholic patients were diagnosed earlier than nonalcoholics (median time to diagnosis, 1 vs 4 days; P=.001) and had shorter hospitalizations (13 vs 23 days; P=.002).
Conclusion
Compared with nonalcoholic patients, alcoholic patients with WE are more likely to present with cerebellar signs and less likely to have ocular signs. Diagnosis may be delayed in nonalcoholic patients. Mortality in the present series was lower than described previously.

Idioma original	Inglés
Páginas (desde-hasta)	899-907
Número de páginas	9
Publicación	Mayo Clin Proc
Volumen	92
N.º	6
DOI	https://doi.org/10.1016/j.mayocp.2017.02.019
Estado	Publicada - jun 2017

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

ODS 3: Salud y bienestar

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10.1016/j.mayocp.2017.02.019

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https://www.scopus.com/pages/publications/85021747003

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Muga-Bustamante, R., Chamorro, AJ., Rosón-Hernández, B., Medina-García, JA., Fernández-Solá, J., Martín-González, MC., Seco-Hernández, E., Novo-Veleiro, I., Suárez-Cuervo, C., Mateos-Díaz, AM., Monte-Secades, R., Machado-Prieto, B., Puerta-Louro, R., Prada-González, C., Fernández-Rial, A., Sabio-Repiso, P., Vázquez-Vigo, R., Antolí-Royo, AC., Gomila-Grange, A., ... Spanish, S. O. I. M. (2017). Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy: A Multicenter Observational Study. Mayo Clin Proc, 92(6), 899-907. https://doi.org/10.1016/j.mayocp.2017.02.019

@article{6efa456df9e74c619d5ff58e9dbcc9ad,

title = "Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy:: A Multicenter Observational Study",

abstract = "Objective To analyze the differences in characteristics and prognosis between alcoholic and nonalcoholic patients with Wernicke encephalopathy (WE). Patients and Methods A retrospective observational cohort of 468 patients diagnosed with WE with at least 2 Caine criteria was selected from all patients discharged with a diagnosis of WE from 21 medical centers in Spain from January 1, 2000, through December 31, 2012. Demographic, clinical, and outcome variables were described. Results Among the 468 patients, the most common risk factor was alcoholism (n=434 [92.7\%]). More than one-third of patients (n=181 [38.7\%]) had the classic WE triad of symptoms (ocular signs, cerebellar dysfunction, and confusion). Among 252 patients for whom magnetic resonance imaging data were available, 135 (53.6\%) had WE-related lesions and 42 (16.7\%) had cerebellar lesions. Of the 468 patients, 25 (5.3\%) died during hospitalization. Alcoholic patients presented more frequently than nonalcoholic patients with cerebellar signs (P=.01) but less frequently with ocular signs (P=.02). Alcoholic patients had a significantly higher frequency of hyponatremia (P=.04) and decreased platelet count (P=.005) compared with nonalcoholics. Alcoholic patients were diagnosed earlier than nonalcoholics (median time to diagnosis, 1 vs 4 days; P=.001) and had shorter hospitalizations (13 vs 23 days; P=.002). Conclusion Compared with nonalcoholic patients, alcoholic patients with WE are more likely to present with cerebellar signs and less likely to have ocular signs. Diagnosis may be delayed in nonalcoholic patients. Mortality in the present series was lower than described previously. ",

author = "R Muga-Bustamante and AJ Chamorro and B Ros{\'o}n-Hern{\'a}ndez and JA Medina-Garc{\'i}a and J Fern{\'a}ndez-Sol{\'a} and MC Mart{\'i}n-Gonz{\'a}lez and E Seco-Hern{\'a}ndez and I Novo-Veleiro and C Su{\'a}rez-Cuervo and AM Mateos-D{\'i}az and R Monte-Secades and B Machado-Prieto and R Puerta-Louro and C Prada-Gonz{\'a}lez and A Fern{\'a}ndez-Rial and P Sabio-Repiso and R V{\'a}zquez-Vigo and AC Antol{\'i}-Royo and A Gomila-Grange and NC Felipe-P{\'e}rez and A Sanvisens-Berg{\'e} and E Ant{\'u}nez-Jorge and CM Fern{\'a}ndez-Rodr{\'i}guez and L Alvela-Su{\'a}rez and A Fidalgo-Navarro and Miguel Marcos and Wernicke-SEMI Group and Group, \{Alcohol and Alcoholism\} and Spanish, \{Society of Internal Medicine (SEMI)\}",

note = "This work was supported in part by the Spanish Society of Internal Medicine Working Group on Alcohol and Alcoholism and by grants from the Ministry of Economy and Competitiveness, the Carlos III Health Institute (Networks for Cooperative Research in Health [RETICS], RD12/0028/0006 and RD12/0028/0008), and the European Regional Development Fund.",

year = "2017",

month = jun,

doi = "10.1016/j.mayocp.2017.02.019",

language = "English",

volume = "92",

pages = "899--907",

number = "6",

}

Muga-Bustamante, R, Chamorro, AJ, Rosón-Hernández, B, Medina-García, JA, Fernández-Solá, J, Martín-González, MC, Seco-Hernández, E, Novo-Veleiro, I, Suárez-Cuervo, C, Mateos-Díaz, AM, Monte-Secades, R, Machado-Prieto, B, Puerta-Louro, R, Prada-González, C, Fernández-Rial, A, Sabio-Repiso, P, Vázquez-Vigo, R, Antolí-Royo, AC, Gomila-Grange, A, Felipe-Pérez, NC, Sanvisens-Bergé, A, Antúnez-Jorge, E, Fernández-Rodríguez, CM, Alvela-Suárez, L, Fidalgo-Navarro, A, Marcos, M, Group, W-SEMI, Group, AAA & Spanish, SOIM 2017, 'Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy: A Multicenter Observational Study', Mayo Clin Proc, vol. 92, n.º 6, pp. 899-907. https://doi.org/10.1016/j.mayocp.2017.02.019

TY - JOUR

T1 - Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy:

T2 - A Multicenter Observational Study

AU - Muga-Bustamante, R

AU - Chamorro, AJ

AU - Rosón-Hernández, B

AU - Medina-García, JA

AU - Fernández-Solá, J

AU - Martín-González, MC

AU - Seco-Hernández, E

AU - Novo-Veleiro, I

AU - Suárez-Cuervo, C

AU - Mateos-Díaz, AM

AU - Monte-Secades, R

AU - Machado-Prieto, B

AU - Puerta-Louro, R

AU - Prada-González, C

AU - Fernández-Rial, A

AU - Sabio-Repiso, P

AU - Vázquez-Vigo, R

AU - Antolí-Royo, AC

AU - Gomila-Grange, A

AU - Felipe-Pérez, NC

AU - Sanvisens-Bergé, A

AU - Antúnez-Jorge, E

AU - Fernández-Rodríguez, CM

AU - Alvela-Suárez, L

AU - Fidalgo-Navarro, A

AU - Marcos, Miguel

AU - Group, Wernicke-SEMI

AU - Group, Alcohol and Alcoholism

AU - Spanish, Society of Internal Medicine (SEMI)

N1 - This work was supported in part by the Spanish Society of Internal Medicine Working Group on Alcohol and Alcoholism and by grants from the Ministry of Economy and Competitiveness, the Carlos III Health Institute (Networks for Cooperative Research in Health [RETICS], RD12/0028/0006 and RD12/0028/0008), and the European Regional Development Fund.

PY - 2017/6

Y1 - 2017/6

N2 - Objective To analyze the differences in characteristics and prognosis between alcoholic and nonalcoholic patients with Wernicke encephalopathy (WE). Patients and Methods A retrospective observational cohort of 468 patients diagnosed with WE with at least 2 Caine criteria was selected from all patients discharged with a diagnosis of WE from 21 medical centers in Spain from January 1, 2000, through December 31, 2012. Demographic, clinical, and outcome variables were described. Results Among the 468 patients, the most common risk factor was alcoholism (n=434 [92.7%]). More than one-third of patients (n=181 [38.7%]) had the classic WE triad of symptoms (ocular signs, cerebellar dysfunction, and confusion). Among 252 patients for whom magnetic resonance imaging data were available, 135 (53.6%) had WE-related lesions and 42 (16.7%) had cerebellar lesions. Of the 468 patients, 25 (5.3%) died during hospitalization. Alcoholic patients presented more frequently than nonalcoholic patients with cerebellar signs (P=.01) but less frequently with ocular signs (P=.02). Alcoholic patients had a significantly higher frequency of hyponatremia (P=.04) and decreased platelet count (P=.005) compared with nonalcoholics. Alcoholic patients were diagnosed earlier than nonalcoholics (median time to diagnosis, 1 vs 4 days; P=.001) and had shorter hospitalizations (13 vs 23 days; P=.002). Conclusion Compared with nonalcoholic patients, alcoholic patients with WE are more likely to present with cerebellar signs and less likely to have ocular signs. Diagnosis may be delayed in nonalcoholic patients. Mortality in the present series was lower than described previously.

AB - Objective To analyze the differences in characteristics and prognosis between alcoholic and nonalcoholic patients with Wernicke encephalopathy (WE). Patients and Methods A retrospective observational cohort of 468 patients diagnosed with WE with at least 2 Caine criteria was selected from all patients discharged with a diagnosis of WE from 21 medical centers in Spain from January 1, 2000, through December 31, 2012. Demographic, clinical, and outcome variables were described. Results Among the 468 patients, the most common risk factor was alcoholism (n=434 [92.7%]). More than one-third of patients (n=181 [38.7%]) had the classic WE triad of symptoms (ocular signs, cerebellar dysfunction, and confusion). Among 252 patients for whom magnetic resonance imaging data were available, 135 (53.6%) had WE-related lesions and 42 (16.7%) had cerebellar lesions. Of the 468 patients, 25 (5.3%) died during hospitalization. Alcoholic patients presented more frequently than nonalcoholic patients with cerebellar signs (P=.01) but less frequently with ocular signs (P=.02). Alcoholic patients had a significantly higher frequency of hyponatremia (P=.04) and decreased platelet count (P=.005) compared with nonalcoholics. Alcoholic patients were diagnosed earlier than nonalcoholics (median time to diagnosis, 1 vs 4 days; P=.001) and had shorter hospitalizations (13 vs 23 days; P=.002). Conclusion Compared with nonalcoholic patients, alcoholic patients with WE are more likely to present with cerebellar signs and less likely to have ocular signs. Diagnosis may be delayed in nonalcoholic patients. Mortality in the present series was lower than described previously.

UR - https://www.scopus.com/pages/publications/85021747003

U2 - 10.1016/j.mayocp.2017.02.019

DO - 10.1016/j.mayocp.2017.02.019

M3 - Article

VL - 92

SP - 899

EP - 907

JO - Mayo Clin Proc

JF - Mayo Clin Proc

IS - 6