Are Psychiatric Inpatients at Risk of Developing Wernicke’s Encephalopathy Being Identified and Adequately Treated?
| Autor: | Marina Chavez, Jessica Nelson, Regina Baronia, Sailatha Bobba, Stephen Manning, Jafreen Ahmed, Medhat Guirguis, Ijeoma Ajufo |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Encephalopathy Wernicke's encephalopathy 03 medical and health sciences 0302 clinical medicine Mentally Ill Persons Humans Psychiatric hospital Medicine Wernicke Encephalopathy Dosing Disease management (health) Psychiatry Retrospective Studies Inpatients business.industry Medical record Disease Management food and beverages Retrospective cohort study General Medicine Middle Aged medicine.disease United States 030227 psychiatry Alcoholism Female Thiamine business 030217 neurology & neurosurgery |
| Zdroj: | The Primary Care Companion For CNS Disorders. 19 |
| ISSN: | 2155-7780 |
| DOI: | 10.4088/pcc.17m02179 |
| Popis: | Objective Wernicke's encephalopathy is caused by thiamine deficiency and occurs predominantly in alcohol-dependent individuals but also develops in those who are malnourished due to other reasons including medical and psychiatric disorders. This study examined the frequency rate and management of Wernicke's encephalopathy in alcohol-dependent and non-alcohol-dependent patients admitted to a psychiatric hospital. Methods Data were retrospectively collected from electronic medical records of psychiatric inpatients admitted to a teaching hospital located in Texas between September 2013 and March 2014. The diagnostic criteria of Caine and colleagues and thiamine dosing strategies were used to identify cases of suboptimal management. Results A total of 486 charts were reviewed. Nine patients (1.85%) had clinical signs of Wernicke's encephalopathy, and 36 (7%, n = 486) were at a high risk for developing the disorder. None of these patients received adequate doses of parenteral thiamine, and of those who were prescribed thiamine, the majority, including high-risk patients, were prescribed oral thiamine at the traditional dose of 100 mg/d. Conclusions The findings suggest that Wernicke's encephalopathy is underdiagnosed and undertreated. Our study also highlights the need for clarifying diagnostic criteria, identifying the risk factors for thiamine deficiency, and improving awareness among physicians about diagnosis, prevention, and adequate treatment of Wernicke's encephalopathy in alcohol-dependent and non-alcohol-dependent patients. |
| Databáze: | OpenAIRE |
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