Thiamine Underused for Critically Ill Patients With AUD

About half of patients with alcohol use disorder (AUD) who are critically ill receive thiamine supplementation, according to a study published online Dec. 7 in the Annals of Internal Medicine.

Noting that thiamine supplementation is recommended for patients with AUD, Rahul D. Pawar, M.D., from Beth Israel Deaconess Medical Center in Boston, and colleagues describe the incidence of thiamine supplementation in patients with AUD and various critical illnesses (alcohol withdrawal, septic shock, traumatic brain injury [TBI], and diabetic ketoacidosis [DKA]) who were admitted between 2010 and 2017. Data were included for 14,998 patients with AUD (mean age, 52.2 years); in-hospital mortality was 9 percent.

The researchers found that 51 percent of the patients with AUD received thiamine supplementation. The incidence of thiamine supplementation was 59, 26, 41, and 24 percent for alcohol withdrawal, septic shock, TBI, and DKA, respectively. Of those receiving thiamine, 52 percent received it within 12 hours of emergency department presentation. Enteral administration was the predominant route of thiamine administration (41 percent).

"Approximately half of patients with AUD and critical illness did not receive thiamine supplementation," the authors write. "This information highlights a potential area for quality improvement."