Objective predictors for delirium tremens based on physiological and metabolic parameters
- Authors: Utkin S.I.1,2, Buzik O.Z.1, Burtsev A.A.1
-
Affiliations:
- Moscow Scientific and Practical Center for Narcology
- I.M. Sechenov First Moscow State Medical University (Sechenovskiy University)
- Issue: Vol 15, No 2 (2024)
- Pages: 163-171
- Section: Клиническая наркология
- URL: https://journals.eco-vector.com/1606-8181/article/view/626372
- DOI: https://doi.org/10.17816/phbn626372
- ID: 626372
Cite item
Abstract
BACKGROUND: The search for markers and predictors of complicated forms of alcoholism, which include alcoholic delirium and acute psychotic reactions with hallucinatory and delusional phenomena, is one of the actual problems of modern addiction medicine. AIM: Clinical validation of a model for early detection of patients at high risk of developing complicated alcohol withdrawal syndrome (AWS) based on laboratory diagnostics. SUBJECTS AND METHODS: A prospective, cohort, observational study was performed. The study included 200 patients; 9 were excluded. The included patients were distributed as follows: uncomplicated AWS, 98 patients (51.3%); alcohol delirium, 67 patients (35.1%); and alcohol-induced psychotic disorder, 26 patients (13.6%). Potassium, sodium, calcium, and platelet count were compared between the groups, and the relationships between sex, age, and potassium levels in patients with alcohol delirium were studied. RESULTS: Potassium, sodium, and platelet count were significantly different in patients with alcohol delirium and in those with uncomplicated AWS and alcohol-induced psychotic disorder. Blood calcium levels were significantly different between patients with alcohol delirium and uncomplicated AWS. Women were found to be less sensitive to metabolic disorders that developed as a result of alcohol consumption, as evidenced by lower incidence of delirium. The high prevalence of alcohol delirium among older patients is a consequence of decompensation of metabolic regulation mechanisms. CONCLUSIONS: Predictive model of alcohol delirium, based on the results of blood potassium level study, proved effectiveness in clinical application.
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
S. I. Utkin
Moscow Scientific and Practical Center for Narcology; I.M. Sechenov First Moscow State Medical University (Sechenovskiy University)
Author for correspondence.
Email: utkin_s_i_1@staff.sechenov.ru
ORCID iD: 0000-0001-7867-1830
SPIN-code: 5153-6237
MD, Cand. Sci. (Medicine), Assistant Professor
Russian Federation, Sechenov University, Moscow 119048, Trubetskaya street, 8, Bild 2; MoscowO. Zh. Buzik
Moscow Scientific and Practical Center for Narcology
Email: buzic58@bk.ru
ORCID iD: 0000-0001-9470-6781
SPIN-code: 7140-5795
MD, Dr. Sci. (Medicine), Professor
Russian Federation, MoscowA. A. Burtsev
Moscow Scientific and Practical Center for Narcology
Email: burtsev@mail.ru
ORCID iD: 0000-0003-2710-1285
SPIN-code: 3639-8319
MD, Dr. Sci. (Medicine)
MoscowReferences
- Klimaev SN, Garin VV, Medvedeva IV, editors. Health care in Russia 2023. Statistical compendium. Moscow, 2023. 179 p. (In Russ.)
- Airagnes G, Ducoutumany G, Laffy-Beaufils B, et al. Alcohol withdrawal syndrome management: Is there anything new? Rev Med Interne. 2019;40(6):373–379. doi: 10.1016/j.revmed.2019.02.001
- Schuckit MA. Recognition and management of withdrawal delirium (delirium tremens). N Engl J Med. 2014;371(22):2109–2113. doi: 10.1056/NEJMra1407298
- Soyka M. Prevalence of alcohol-induced psychotic disorders. Eur Arch Psychiatry Clin Neurosci. 2008;258(5):317–318. doi: 10.1007/s00406-008-0767-1
- Perälä J, Kuoppasalmi K, Pirkola S, et al. Alcohol-induced psychotic disorder and delirium in the general population. Br J Psychiatry. 2010;197(3):200–206. doi: 10.1192/bjp.bp.109.070797
- Utkin SI, Buzik OZh, Dyuzhev DV. Objective predictors for delirium tremens based on physiological and metabolic indicators. Journal of addiction problems. 2021;(12):17–30. EDN: AYLAHW doi: 10.47877/0234-0623_2021_12_17
- Bodhinathan K, Slesinger PA. Molecular mechanism underlying ethanol activation of G-protein-gated inwardly rectifying potassium channels. PNAS USA. 2013;110(45):18309–18314. doi: 10.1073/pnas.1311406110
- Rubini ME, Kleeman CR, Lamdin E. Studies on alcohol diuresis. I. The effect of ethyl alcohol ingestion on water, electrolyte and acid-base metabolism. J Clin Invest. 1955;34(3):439–447. doi: 10.1172/JCI103092
- Liamis GL, Milionis HJ, Rizos EC, et al. Mechanisms of hyponatraemia in alcohol patients. Alcohol Alcohol. 2000;35(6):612–616. doi: 10.1093/alcalc/35.6.612
- Alberts B. Molecular biology of the cell. 6th ed. Garland Science, 2015. 1465 p.
Supplementary files
![](/img/style/loading.gif)