Differences Between Alcoholic and Nonalcoholic Patients With Wernicke Encephalopathy: A Multicenter Observational Study
Por:
Chamorro, AJ, Roson-Hernandez, B, Medina-Garcia, JA, Muga-Bustamante, R, Fernandez-Sola, J, Martin-Gonzalez, MC, Seco-Hernandez, E, Novo-Veleiro, I, Suarez-Cuervo, C, Mateos-Diaz, AM, Monte-Secades, R, Machado-Prieto, B, Puerta-Louro, R, Prada-Gonzalez, C, Fernandez-Rial, A, Sabio-Repiso, P, Vazquez-Vigo, R, Antoli-Royo, AC, Gomila-Grange, A, Felipe-Perez, NC, Sanvisens-Berge, A, Antunez-Jorge, E, Fernandez-Rodriguez, CM, Alvela-Suarez, L, Fidalgo-Navarro, A and Marcos, M
Publicada:
1 jun 2017
Categoría:
Medicine (miscellaneous)
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. (C) 2017 Mayo Foundation for Medical Education and Research
Filiaciones:
Chamorro, AJ:
Hosp Univ Salamanca, Dept Internal Med, Salamanca, Spain
Roson-Hernandez, B:
Hosp Univ Bellvitge, Dept Internal Med, Barcelona, Spain
Medina-Garcia, JA:
Hosp Univ Nuestra Senora Candelaria, Dept Internal Med, Tenerife, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Internal Med, Badalona, Spain
Fernandez-Sola, J:
Hosp Clin Barcelona, Dept Internal Med, Barcelona, Spain
Martin-Gonzalez, MC:
Hosp Univ Canarias, Dept Internal Med, Tenerife, Spain
Seco-Hernandez, E:
Complexo Hosp Univ Ourense, Dept Internal Med, Orense, Spain
Novo-Veleiro, I:
Complexo Hosp Univ de Santiago, Dept Internal Med, Santiago De Compostela, Spain
Suarez-Cuervo, C:
Hosp Univ Cent Asturias, Dept Internal Med, Oviedo, Spain
Mateos-Diaz, AM:
Hosp Univ Salamanca, Dept Internal Med, Salamanca, Spain
Monte-Secades, R:
Hosp Univ Lucus Augusti, Dept Internal Med, Lugo, Spain
Machado-Prieto, B:
Complexo Hosp Univ Vigo, Dept Internal Med, Vigo, Spain
Puerta-Louro, R:
Hosp Povisa, Dept Internal Med, Vigo, Spain
Prada-Gonzalez, C:
Hosp Bierzo, Dept Internal Med, Ponferrada Leon, Spain
Fernandez-Rial, A:
Complexo Hosp Univ Ferrol, Dept Internal Med, La Coruna, Spain
Sabio-Repiso, P:
Hosp Clin San Carlos, Dept Internal Med, Madrid, Spain
Vazquez-Vigo, R:
Complexo Hosp Univ A Coruna, Dept Internal Med, La Coruna, Spain
Antoli-Royo, AC:
Complejo Asistencial Avila, Dept Internal Med, Avila, Spain
Gomila-Grange, A:
Hosp Univ Bellvitge, Dept Internal Med, Barcelona, Spain
Felipe-Perez, NC:
Hosp Univ Nuestra Senora Candelaria, Dept Internal Med, Tenerife, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Internal Med, Badalona, Spain
Antunez-Jorge, E:
Hosp Clin Barcelona, Dept Internal Med, Barcelona, Spain
Fernandez-Rodriguez, CM:
Hosp Univ Canarias, Dept Internal Med, Tenerife, Spain
Alvela-Suarez, L:
Complexo Hosp Univ de Santiago, Dept Internal Med, Santiago De Compostela, Spain
Fidalgo-Navarro, A:
Hosp Univ Cent Asturias, Dept Internal Med, Oviedo, Spain
Marcos, M:
Hosp Univ Salamanca, Dept Internal Med, Salamanca, Spain
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