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Alcohol-related brain injury: An unrecognized problem in acute medicine.
Alcohol ( IF 2.5 ) Pub Date : 2020-06-02 , DOI: 10.1016/j.alcohol.2020.05.005
Andrew Thompson 1 , Paul Richardson 2 , Munir Pirmohamed 1 , Lynn Owens 3
Affiliation  

Alcohol-related brain injury (ARBI) is an unrecognized and therefore untreated consequence of alcohol use disorder. Here, we explore a 12-month period prevalence of alcohol-related brain injury (ARBI) in alcohol use disorder patients. Inpatients aged ≥18 years reviewed by the Alcohol Care Team's Specialist Nurses between April 1, 2017 and March 31, 2018 were eligible for the study (n = 1276). Screening identified a high-risk subset of patients who matched at least one of the following: 1) more than three alcohol-related admissions in one year; 2) two alcohol-related admissions in any given 30-day period; 3) patient or their significant other had concerns regarding cognition. The high-risk patients were assessed for evidence of ARBI using the Montreal Cognitive Assessment Tool (MoCA). The primary measure of interest was MoCA ≤23. Analysis was conducted between subgroups of the study population to identify prevalence rate ratios for matching the high-risk screening criteria, and MoCA ≤23 in high-risk patients. Two hundred and five patients were identified as high risk for ARBI. The period prevalence rates in this high-risk group for patients with a MoCA ≤23 was 36.1%. Those under the age of 35 years were significantly less likely to match the high-risk criteria. Patients that were homeless or staying in hostels were more likely to match the high-risk criteria and were also at increased risk of MoCA ≤23, compared with those living with family members. In summary, ARBI is common in patients with AUD attending acute hospitals. ARBI is often not diagnosed, and thus further work is required to improve screening for, and identification of, these patients to develop evidence-based clinical pathways that optimize care.



中文翻译:

酒精相关的脑损伤:急性医学中一个未被认识的问题。

酒精相关性脑损伤 (ARBI) 是酒精使用障碍的一种未被认识且因此未经治疗的后果。在这里,我们探讨了酒精使用障碍患者 12 个月内酒精相关脑损伤 (ARBI) 的患病率。酒精护理团队的专科护士在 2017 年 4 月 1 日至 2018 年 3 月 31 日期间审查的 18 岁以上住院患者符合本研究的条件(n = 1276)。筛查确定了符合以下至少一项的高风险患者子集:1) 一年内超过 3 次与酒精相关的入院;2) 在任何给定的 30 天内两次与酒精有关的入院;3) 患者或其重要的其他人对认知存在担忧。使用蒙特利尔认知评估工具(MoCA)评估高危患者的 ARBI 证据。感兴趣的主要指标是 MoCA ≤23。在研究人群的亚组之间进行分析,以确定与高风险筛查标准相匹配的患病率比率,高风险患者的 MoCA ≤ 23。205 名患者被确定为 ARBI 的高风险。对于 MoCA ≤ 23 的患者,该高危组的经期患病率为 36.1%。35 岁以下的人符合高风险标准的可能性要小得多。与与家人同住的患者相比,无家可归或住在旅馆的患者更可能符合高风险标准,并且 MoCA ≤23 的风险也更高。总之,ARBI 在急诊医院就诊的 AUD 患者中很常见。ARBI 通常没有被诊断出来,因此需要进一步的工作来改进筛查和识别,

更新日期:2020-06-02
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