Vitamin deficiencies in acutely intoxicated patients in the ED

Am J Emerg Med. 2008 Sep;26(7):792-5. doi: 10.1016/j.ajem.2007.10.003.

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 B(12), 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 B(12) 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 B(12) 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.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Alcoholic Intoxication / blood
  • Alcoholic Intoxication / complications*
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Folic Acid / blood
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Thiamine / therapeutic use
  • Thiamine Deficiency / blood
  • Thiamine Deficiency / drug therapy
  • Thiamine Deficiency / etiology*
  • Vitamin B 12 Deficiency / blood
  • Vitamin B Complex / therapeutic use

Substances

  • Vitamin B Complex
  • Folic Acid
  • Thiamine