Biomarkers of alcohol abuse potentially predict delirium, delirium duration and mortality in critically ill patients
Nikolaus Schreiber,
Alexander C. Reisinger,
Stefan Hatzl,
Nikolaus Schneider,
Laura Scholz,
Markus Herrmann,
Michael Kolland,
Max Schuller,
Alexander H. Kirsch,
Kathrin Eller,
Christiane Kink,
Simon Fandler-Höfler,
Alexander R. Rosenkranz,
Gerald Hackl,
Philipp Eller
Affiliations
Nikolaus Schreiber
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria; Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Alexander C. Reisinger
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Stefan Hatzl
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Nikolaus Schneider
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Laura Scholz
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Markus Herrmann
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
Michael Kolland
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Max Schuller
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Alexander H. Kirsch
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Kathrin Eller
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Christiane Kink
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Simon Fandler-Höfler
Department of Neurology, Medical University Graz, Graz, Austria
Alexander R. Rosenkranz
Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
Gerald Hackl
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria
Philipp Eller
Department of Internal Medicine, Intensive Care Unit, Medical University of Graz, Graz, Austria; Corresponding author
Summary: Carbohydrate-deficient transferrin (CDT) and the γ-glutamyltransferase-CDT derived Anttila-Index are established biomarkers for sustained heavy alcohol consumption and their potential role to predict delirium and mortality in critically ill patients is not clear. In our prospective observational study, we included 343 consecutive patients admitted to our ICU, assessed the occurrence of delirium and investigated its association with biomarkers of alcohol abuse measured on the day of ICU admission. 35% of patients developed delirium during ICU stay. We found significantly higher CDT levels (p = 0.011) and Anttila-Index (p = 0.001) in patients with delirium. CDT above 1.7% (OR 2.06), CDT per percent increase (OR 1.26, AUROC 0.75), and Anttila-Index per unit increase (OR 1.28, AUROC 0.74) were associated with delirium development in adjusted regression models. Anttila-Index and CDT also correlated with delirium duration exceeding 5 days. Additionally, Anttila-Index above 4, Anttila-Index per unit increase, and CDT per percent increase were independently associated with hospital mortality.
