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The usefulness of direct ethanol metabolites in assessing alcohol intake in nonintoxicated male patients in an emergency room setting

Kip, Miriam Julia; Spies, Claudia Doris; Neumann, Tim; Nachbar, Yvonne; Alling, Christer LU ; Aradottir, Steina LU ; Weinmann, Wolfgang and Wurst, Friedrich Martin (2008) In Alcoholism: Clinical and Experimental Research 32(7). p.1284-1291
Abstract
Background: A major part of medical pathology in internal medicine is associated with chronic alcoholism. The aim of the current study was to investigate whether screening for Alcohol Use Disorders (AUD) can be improved through determination of direct ethanol metabolites compared to traditional biological state markers, the Alcohol Use Disorders Identification Test (AUDIT) and additional self-reports beyond the detection time period of a positive blood alcohol concentration (BAC). Methods: A total of 74 blood alcohol negative male patients who presented at the emergency room with either thoracic or gastrointestinal complaints were included. Phosphatidylethanol (PEth) was determined in whole blood, and ethyl glucuronide (EtG) in serum and... (More)
Background: A major part of medical pathology in internal medicine is associated with chronic alcoholism. The aim of the current study was to investigate whether screening for Alcohol Use Disorders (AUD) can be improved through determination of direct ethanol metabolites compared to traditional biological state markers, the Alcohol Use Disorders Identification Test (AUDIT) and additional self-reports beyond the detection time period of a positive blood alcohol concentration (BAC). Methods: A total of 74 blood alcohol negative male patients who presented at the emergency room with either thoracic or gastrointestinal complaints were included. Phosphatidylethanol (PEth) was determined in whole blood, and ethyl glucuronide (EtG) in serum and urine samples. Traditional biological state markers [carbohydrate deficient transferrin (%CDT), gamma glutamyl transpeptidase (GGT), mean corpuscular volume (MCV)] were determined. The AUDIT was obtained and furthermore, all patients completed an additional self-report of alcohol consumption. Patients were divided into two (2) groups: AUDIT scores < 8 and AUDIT scores >= 8. Results: After assessment of the AUDIT, patients were allocated to one of the following groups: patients with AUDIT scores < 8 (n = 52) and with AUDIT scores >= 8 (n = 22). Twenty-five percent of the patients with AUDIT scores below the cut-off (n = 13/52) were tested positive for both PEth and UEtG. Of the patients who declared to be sober during the past 12 months, 38.5% were tested positive for PEth and UEtG. PEth discriminated similarly as %CDT for AUDIT scores >= 8 (AUC: 0.672; 95%CI 0.524 to 0.821). Self-reports of alcohol consumption were unreliable. Conclusion: Determination of direct ethanol metabolites such as PEth and UEtG provides additional evidence in screening for AUD in an ER setting. Determination of PEth might be considered complementary with or alternatively to %CDT. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
alcohol use disorders, self-reports, direct ethanol metabolites, traditional biological state markers, emergency room, internal medicine
in
Alcoholism: Clinical and Experimental Research
volume
32
issue
7
pages
1284 - 1291
publisher
Wiley-Blackwell
external identifiers
  • wos:000257692600019
  • scopus:54749135863
ISSN
0145-6008
DOI
10.1111/j.1530-0277.2008.00696.x
language
English
LU publication?
yes
id
87bce474-b94c-4a65-9442-be136282717c (old id 1255217)
date added to LUP
2008-10-16 13:40:58
date last changed
2017-07-23 03:57:53
@article{87bce474-b94c-4a65-9442-be136282717c,
  abstract     = {Background: A major part of medical pathology in internal medicine is associated with chronic alcoholism. The aim of the current study was to investigate whether screening for Alcohol Use Disorders (AUD) can be improved through determination of direct ethanol metabolites compared to traditional biological state markers, the Alcohol Use Disorders Identification Test (AUDIT) and additional self-reports beyond the detection time period of a positive blood alcohol concentration (BAC). Methods: A total of 74 blood alcohol negative male patients who presented at the emergency room with either thoracic or gastrointestinal complaints were included. Phosphatidylethanol (PEth) was determined in whole blood, and ethyl glucuronide (EtG) in serum and urine samples. Traditional biological state markers [carbohydrate deficient transferrin (%CDT), gamma glutamyl transpeptidase (GGT), mean corpuscular volume (MCV)] were determined. The AUDIT was obtained and furthermore, all patients completed an additional self-report of alcohol consumption. Patients were divided into two (2) groups: AUDIT scores &lt; 8 and AUDIT scores &gt;= 8. Results: After assessment of the AUDIT, patients were allocated to one of the following groups: patients with AUDIT scores &lt; 8 (n = 52) and with AUDIT scores &gt;= 8 (n = 22). Twenty-five percent of the patients with AUDIT scores below the cut-off (n = 13/52) were tested positive for both PEth and UEtG. Of the patients who declared to be sober during the past 12 months, 38.5% were tested positive for PEth and UEtG. PEth discriminated similarly as %CDT for AUDIT scores &gt;= 8 (AUC: 0.672; 95%CI 0.524 to 0.821). Self-reports of alcohol consumption were unreliable. Conclusion: Determination of direct ethanol metabolites such as PEth and UEtG provides additional evidence in screening for AUD in an ER setting. Determination of PEth might be considered complementary with or alternatively to %CDT.},
  author       = {Kip, Miriam Julia and Spies, Claudia Doris and Neumann, Tim and Nachbar, Yvonne and Alling, Christer and Aradottir, Steina and Weinmann, Wolfgang and Wurst, Friedrich Martin},
  issn         = {0145-6008},
  keyword      = {alcohol use disorders,self-reports,direct ethanol metabolites,traditional biological state markers,emergency room,internal medicine},
  language     = {eng},
  number       = {7},
  pages        = {1284--1291},
  publisher    = {Wiley-Blackwell},
  series       = {Alcoholism: Clinical and Experimental Research},
  title        = {The usefulness of direct ethanol metabolites in assessing alcohol intake in nonintoxicated male patients in an emergency room setting},
  url          = {http://dx.doi.org/10.1111/j.1530-0277.2008.00696.x},
  volume       = {32},
  year         = {2008},
}