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首页> 外文期刊>Psychosomatics >Severe Infections are Common in Thiamine Deficiency and May be Related to Cognitive Outcomes: A Cohort Study of 68 Patients With Wernicke-Korsakoff Syndrome
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Severe Infections are Common in Thiamine Deficiency and May be Related to Cognitive Outcomes: A Cohort Study of 68 Patients With Wernicke-Korsakoff Syndrome

机译：严重感染在硫胺素缺乏症中很常见，并且可能与认知结果有关：一项针对68名Wernicke-Korsakoff综合征患者的队列研究

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摘要

Background: Wernicke encephalopathy can have different clinical outcomes. Although infections may precipitate the encephalopathy itself, it is unknown whether infections also modify the long-term outcome in patients developing Korsakoff syndrome. Objective: To determine whether markers of infection, such as white blood cell (WBC) counts and absolute neutrophil counts in the Wernicke phase, are associated with cognitive outcomes in the end-stage Korsakoff syndrome. Method: Retrospective, descriptive study of patients admitted to Slingedael Korsakoff Center, Rotterdam, The Netherlands. Hospital discharge letters of patients with Wernicke encephalopathy were searched for relevant data on infections present upon hospital admission. Patients were selected for further analysis if data were available on WBC counts in the Wernicke phase and at least 1 of 6 predefined neuropsychological tests on follow-up. Results: Infections were reported in 35 of 68 patients during the acute phase of Wernicke-Korsakoff syndrome meningitis (1), pneumonia (14), urinary tract infections (9), acute abdominal infections (4), sepsis (5) empyema, (1) and infection "of unknown origin" (4). The neuropsychological test results showed sign cant lower scores on the Cambridge Cognitive Examination nonmemory section with increasing white blood cell counts (Spearman rank correlation, rho = -0.34; 95% CI: -0.57 to -0.06; 44 patients) and on the "key search test" of the behavioral assessment of the dysexecutive syndrome with increasing absolute neutrophil counts (rho= -0.85; 95% CI: -0.97 to -0.42; 9 patients). Conclusions: Infections may be the presenting manifestation of thiamine deficiency. Patients with Wernicke-Korsakoff syndrome who suffered from an infection during the acute phase are at risk of worse neuropsychological outcomes on follow-up.
机译：背景：Wernicke脑病可以有不同的临床结果。尽管感染可能会引起脑病本身，但尚不清楚感染是否还会改变患上Korsakoff综合征的患者的长期结局。目的：确定感染标记，例如韦尼克阶段的白细胞（WBC）计数和绝对中性粒细胞计数是否与晚期Korsakoff综合征的认知结局相关。方法：对荷兰鹿特丹Slingedael Korsakoff中心收治的患者进行回顾性描述性研究。搜索韦尼克脑病患者的出院信，以了解入院时出现感染的相关数据。如果可以获取Wernicke阶段WBC计数的数据以及随访中6项预定义的神经心理学测试中的至少1项，则选择患者进行进一步分析。结果：在Wernicke-Korsakoff综合征脑膜炎（1），肺炎（14），尿路感染（9），急性腹部感染（4），败血症（5）脓胸，（ 1）和“未知来源”感染（4）。神经心理学测试结果显示，在剑桥认知考试非记忆部分，白细胞计数增加（斯皮尔曼等级相关性，rho = -0.34; 95％CI：-0.57至-0.06; 44位患者）以及“关键搜索疗法”对伴有绝对嗜中性白血球计数增加的功能障碍综合症的行为进行评估（rho = -0.85; 95％CI：-0.97至-0.42; 9位患者）。结论：感染可能是硫胺素缺乏的表现。在急性期感染的Wernicke-Korsakoff综合征患者在随访时有可能出现神经心理学结果恶化的风险。

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