정신과에 협진 의뢰된 입원 환자에서의 베르니케뇌병증 예측을 위한 의사 결정 모델 개발

Development of Decision Model for Predicting Wernicke Encephalopathy in Inpatients With Psychiatric Consultation

Objectives: To determine predictive factors associated with the onset of Wernicke encephalopathy (WE) and produce a decision tree predicting patients prone to developing WE. Methods: Demographic, clinical, and laboratory data and the consultation notes of 314 inpatient alcohol use disorder consultation cases were collected. Receiver operative characteristic curve analysis was performed to identify the predictors of WE development. Results: Of the patients with alcohol use disorder, 34.08% developed WE, and 43.93% of those were also diagnosed with hepatic encephalopathy. Delirium history was a predictive factor for patients with alcohol use disorder, with the highest statistical significance, and 54.8% of the patients with prior delirium history developed WE. Hemoglobin (Hb) levels <12.1 g/dL and alanine aminotransferase (PT) levels ≥25 IU/L were the next most significant predictive factors. For patients with alcohol use disorder with altered mental status, a Hb level of 14.4 g/dL was a predictive factor with the highest statistical significance, and 73.3% of patients with Hb levels <14.4 g/dL developed WE. Total bilirubin levels ≥1.1 mg/dL and C-reactive protein (CRP) ≥2.6 mg/dL were the next most significant predictive factors. Conclusion: Assessing delirium history, Hb, and PT levels in patients with alcohol use disorder and Hb, total bilirubin, and CRP levels in patients with alcohol use disorder with altered mental status can help to evaluate the risk of developing WE.