Abstract
This naturalistic study among patients with alcohol dependence examined whether routine blood biomarkers could help to identify patients with high risk for relapse after withdrawal treatment. In a longitudinal study with 6-month follow-up among 133 patients with alcohol dependence who received inpatient alcohol withdrawal treatment, we investigated the usefulness of routine blood biomarkers and clinical and sociodemographic factors for potential outcome prediction and risk stratification. Baseline routine blood biomarkers (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT/GPT], aspartate aminotransferase [AST/GOT], mean cell volume of erythrocytes [MCV]), and clinical and sociodemographic characteristics were recorded at admission. Standardized 6 months’ follow-up assessed outcome variables continuous abstinence, days of continuous abstinence, daily alcohol consumption and current abstinence. The combined threshold criterion of an AST:ALT ratio > 1.00 and MCV > 90.0 fl helped to identify high-risk patients. They had lower abstinence rates (P = 0.001), higher rates of daily alcohol consumption (P < 0.001) and shorter periods of continuous abstinence (P = 0.027) compared with low-risk patients who did not meet the threshold criterion. Regression analysis confirmed our hypothesis that the combination criterion is an individual baseline variable that significantly predicted parts of the respective outcome variances. Routinely assessed indirect alcohol biomarkers help to identify patients with high risk for relapse after alcohol withdrawal treatment. Clinical decision algorithms to identify patients with high risk for relapse after alcohol withdrawal treatment could include classical blood biomarkers in addition to clinical and sociodemographic items.
Highlights
Alcohol use disorder (AUD) is a severe, chronic substance use disorder with a significant individual and socio-economic burden; it is highly prevalent and affects approx. 100 million people globally [12]
We investigated the potential of biological and non-biological factors to estimate the risk for relapse after inpatient withdrawal treatment
On the basis of electronic records, we identified 338 patients (71.3% male, 28.7% female, mean [SD] age: 46.7 [12.6] years) with a recorded diagnosis of alcohol dependence (AD) according to ICD-10 who had received ≥ 5 days of qualified (extended) withdrawal treatment (QWT) in the period of interest
Summary
Alcohol use disorder (AUD) is a severe, chronic substance use disorder with a significant individual and socio-economic burden; it is highly prevalent and affects approx. 100 million people globally [12]. A previous study investigated the ability of a combination of an AST:ALT ratio > 1.00 and an MCV > 90.0 fl to identify patients with alcohol dependence (AD) in a cohort of individuals with and without physical diseases and with and without elevated transaminase levels [17]. The combination of these routine blood biomarkers resulted in a remarkably high sensitivity of 97.3% and specificity of 88.9% [17]
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