November 10, 2017

Simple Blood Test Identifies Critically Ill Patients Who Misuse Alcohol

MAYWOOD, Ill -- November 10, 2017 -- A simple blood test for a compound called phosphatidylethanol (PEth) can accurately identify critically ill patients who misuse alcohol, according to a study published in the journal Alcoholism: Clinical & Experimental Research.

The finding is important because hospitalised patients who misuse alcohol tend to have worse outcomes.

If validated in further studies, the PEth test could help doctors anticipate and perhaps ward off alcohol-related complications such as organ failure and impaired healing of wounds and bones.

Alcohol misuse is defined as heavy drinking (≥1 drinks/day for women and ≥2 drinks/day for men) and/or binge drinking (≥4 drinks per occasion for women and ≥5 drinks for men).

Current methods to identify alcohol misuse are problematic. For example, many critically ill patients in intensive care lack the capacity to answer questions about alcohol use, and testing blood alcohol concentration does not distinguish among different types of alcohol use, such as heavy daily use or occasional binge drinking.

An alternative test measures a compound in the blood that is a biomarker of alcohol use. With a half-life of 4 to 12 days, PEth lasts much longer in the body than blood alcohol concentration. PEth remains detectable for up to 3 weeks.

Majid Afshar, MD, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, and colleagues enrolled 122 adults at Loyola University Medical Center, and the University of Colorado, Denver, Colorado, into their study.

There were a total of 33 critically ill patients treated in intensive care and burn units, 51 were treated in an alcohol detoxification unit, and 38 served as healthy controls.

Alcohol misuse was determined by giving participants the Alcohol Use Disorders Identification Test, which asks questions such as how often a participant binge drinks, is unable to stop drinking or feels remorseful about drinking.

The study found that a PEth level of at least 250 ng/ml was 88.7% accurate in identifying participants who display alcohol misuse and a level higher than 400 ng/ml was 83% accurate in identifying those who showed severe alcohol misuse.

The study is the first to examine the role PEth could play in critically ill patients. The findings “demonstrate good diagnostic accuracy for PEth in discriminating alcohol misuse, with useful cut-points to risk-stratify patients,” the authors concluded. “Further validation in a more representative sample of critically ill patients is needed prior to clinical and research application.”

Reference: DOI: 10.1111/acer.13471

SOURCE: Loyola University Health System

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