Abstract
Objective
Physicians often administer intravenous multivitamins to intoxicated patients in the
emergency department (ED); however, this practice is not supported by evidence from
any prior study. We determined the prevalences of vitamin deficiencies in patients
presenting to our ED with alcohol intoxication.
Methods
This study was a prospective, cross-section, observational study of a convenience
sample of ED patients presenting with acute alcohol intoxication. Patients were tested
for B12, folate, and thiamine levels as add-ons to their blood samples.
Results
Seventy-seven patients were included in the final analysis. The mean age was 46 years,
and 19% were female; the mean blood alcohol level was 280 mg/dL. Of 75 patients, no
one (0%) had low B12 or folate levels (95% confidence interval, 0-0.05); 6 (15%) of 39 patients had low
thiamine levels (95% confidence interval, 0.06-0.31). Of these 6 patients, none exhibited
clinical signs of thiamine deficiency.
Conclusions
In our ED, patients with acute ethanol intoxication do not have B12 or folate deficiencies. A significant minority (15%) of patients have thiamine deficiency;
its clinical significance is unclear. Widespread administration of multivitamins is
unwarranted by these findings, but thiamine may be considered.
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References
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- The Royal College of Physicians report on alcohol: guidelines for managing Wernicke's encephalopathy in the accident and emergency department.Alcohol Alcohol. 2002; 37 ([Erratum in: Alcohol Alcohol. 2003 May-Jun;38(3):291]): 513-521
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Article Info
Publication History
Accepted:
October 5,
2007
Received in revised form:
September 17,
2007
Received:
May 20,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.