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住院酒精戒断期间的营养状况

Nutritional Status During Inpatient Alcohol Detoxification.

作者信息

Gautron Marie-Astrid, Questel Frank, Lejoyeux Michel, Bellivier Frank, Vorspan Florence

机构信息

Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, 200 rue du Faubourg Saint Denis, 75475 Paris Cedex 10, France.

Département de Psychiatrie et d'Addictologie, Hôpital Bichat, AP-HP, 46 rue Henri Huchard 75877 Paris Cedex 18, France.

出版信息

Alcohol Alcohol. 2018 Jan 1;53(1):64-70. doi: 10.1093/alcalc/agx086.

Abstract

AIMS

As low rates of thiamine are thought to be implicated in alcohol-related cognitive disorders, we wanted to assess patients with alcohol use disorders (AUD) during detoxification for their nutritional status and test if vitamins blood levels were associated with a surrogate of cognitive impairment.

METHODS

We performed a retrospective chart review of medical records of 94 consecutive patients hospitalized for alcohol detoxification in a specialized addiction medicine department. Nutritional status was assessed with Body Mass Index (BMI). Vitamins blood levels were available for 80 patients, but thiamine only for 52 patients. The Montreal Cognitive Assessment (MoCA) score was used to screen for cognitive impairment at Day 10 of entry and was available in 59 patients. A binary logistic regression was performed to identify factors associated with MoCA scores below the threshold (26 points).

RESULTS

The mean BMI was 23.28 ± 3.78 kg/m2 and 8.79% of weighted patients qualified for malnutrition. The mean MoCA score was 22.75 ± 4.88 points, and 66% of tested patients were below the threshold of suspected cognitive impairment. No low blood thiamine level was found. In multivariate analysis, BMI, but not vitamins blood rates, was significantly associated with a pathological MoCA screening test.

CONCLUSION

Clinical examination is more sensitive than biomarkers to determine malnourished AUD patients who are at-risk for cognitive impairment. Malnourished patients with AUD should receive a full neuropsychological testing.

SUMMARY

This retrospective chart review study screened for cognitive disorders during alcohol inpatient detoxification with the MoCA test. Body mass index, but not vitamins blood rates, was associated with a pathological MoCA. Clinical examination is more sensitive than biomarkers to determine malnourished AUD patients who are at-risk for cognitive impairment.

摘要

目的

由于认为硫胺素水平低与酒精相关的认知障碍有关,我们希望在酒精使用障碍(AUD)患者解毒期间评估其营养状况,并测试血液中维生素水平是否与认知障碍的替代指标相关。

方法

我们对一家专门的成瘾医学科连续94例因酒精解毒住院的患者的病历进行了回顾性图表审查。用体重指数(BMI)评估营养状况。80例患者可获得血液维生素水平,但仅52例患者可获得硫胺素水平。在入院第10天使用蒙特利尔认知评估(MoCA)评分筛查认知障碍,59例患者有该评分。进行二元逻辑回归以确定与低于阈值(26分)的MoCA评分相关的因素。

结果

平均BMI为23.28±3.78kg/m²,8.79%的加权患者符合营养不良标准。平均MoCA评分为22.75±4.88分,66%的受试患者低于疑似认知障碍阈值。未发现血液硫胺素水平低的情况。在多变量分析中,BMI而非血液维生素水平与病理性MoCA筛查试验显著相关。

结论

在确定有认知障碍风险的营养不良AUD患者方面,临床检查比生物标志物更敏感。营养不良的AUD患者应接受全面的神经心理学测试。

总结

这项回顾性图表审查研究通过MoCA测试筛查了酒精住院解毒期间的认知障碍。体重指数而非血液维生素水平与病理性MoCA相关。在确定有认知障碍风险的营养不良AUD患者方面,临床检查比生物标志物更敏感。

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