Schreiber Nikolaus, Reisinger Alexander C, Hatzl Stefan, Schneider Nikolaus, Scholz Laura, Herrmann Markus, Kolland Michael, Schuller Max, Kirsch Alexander H, Eller Kathrin, Kink Christiane, Fandler-Höfler Simon, Rosenkranz Alexander R, Hackl Gerald, Eller Philipp
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria.
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria.
iScience. 2023 Sep 26;26(10):108044. doi: 10.1016/j.isci.2023.108044. eCollection 2023 Oct 20.
Carbohydrate-deficient transferrin (CDT) and the γ-glutamyltransferase-CDT derived Anttila-Index are established biomarkers for sustained heavy alcohol consumption and their potential role to predict delirium and mortality in critically ill patients is not clear. In our prospective observational study, we included 343 consecutive patients admitted to our ICU, assessed the occurrence of delirium and investigated its association with biomarkers of alcohol abuse measured on the day of ICU admission. 35% of patients developed delirium during ICU stay. We found significantly higher CDT levels (p = 0.011) and Anttila-Index (p = 0.001) in patients with delirium. CDT above 1.7% (OR 2.06), CDT per percent increase (OR 1.26, AUROC 0.75), and Anttila-Index per unit increase (OR 1.28, AUROC 0.74) were associated with delirium development in adjusted regression models. Anttila-Index and CDT also correlated with delirium duration exceeding 5 days. Additionally, Anttila-Index above 4, Anttila-Index per unit increase, and CDT per percent increase were independently associated with hospital mortality.
缺糖转铁蛋白（CDT）和γ-谷氨酰转移酶衍生的CDT安蒂拉指数是长期大量饮酒的既定生物标志物，但其在预测重症患者谵妄和死亡率方面的潜在作用尚不清楚。在我们的前瞻性观察研究中，我们纳入了343例连续入住我们重症监护病房（ICU）的患者，评估谵妄的发生情况，并调查其与ICU入院当天测量的酒精滥用生物标志物之间的关联。35%的患者在ICU住院期间出现谵妄。我们发现谵妄患者的CDT水平（p = 0.011）和安蒂拉指数（p = 0.001）显著更高。在调整后的回归模型中，CDT高于1.7%（比值比[OR] 2.06）、CDT每增加1%（OR 1.26，曲线下面积[AUROC] 0.75）以及安蒂拉指数每增加一个单位（OR 1.28，AUROC 0.74）均与谵妄的发生相关。安蒂拉指数和CDT也与谵妄持续时间超过5天相关。此外，安蒂拉指数高于4、安蒂拉指数每增加一个单位以及CDT每增加1%均与医院死亡率独立相关。
