Neutrophil-lymphocyte ratio as a predictor of delirium tremens in hospitalized patients with alcohol withdrawal

Yıldırım, Yusuf Ezel; Umut, Gökhan; Evren, Cüneyt; Yeral, Eylül; Secerli, Hikmet

doi:10.1016/j.alcohol.2022.12.004

Cited by 2 publications

(11 citation statements)

References 48 publications

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“…This work shows an increase in the WBC count in both groups of patients compared to healthy individuals. This result is consistent with a recent study showing that patients with DT have significantly higher WBC counts than patients without DT [12]. The increased WBC found in this study may be associated with increased neutrophils.…”

Section: Blood Biomarkers In Aws Patients With and Without Dtsupporting

confidence: 94%

“…The increased WBC found in this study may be associated with increased neutrophils. There is also evidence that patients with DT are characterized by a decreased lymphocyte level in peripheral blood [12]. In our study, the lymphocyte count also decreased, but did not reach the threshold of statistical significance (p = 0.16).…”

Section: Blood Biomarkers In Aws Patients With and Without Dtcontrasting

confidence: 77%

“…A recent 2023 paper showed that leukocyte and neutrophil counts, and neutrophil-to-lymphocyte or platelet-to-lymphocyte ratios, are increased in AWS patients with DT compared to patients without DT [12]. Interestingly, lymphocyte and platelet levels are conversely significantly lower in DT patients [12]. Silczuk et al also indicate that thrombocytopenia develops in patients with DT [25].…”

Section: Introductionmentioning

confidence: 99%

“…There are few studies describing changes in hematological and inflammatory markers in DT patients. A recent 2023 paper showed that leukocyte and neutrophil counts, and neutrophil-to-lymphocyte or platelet-to-lymphocyte ratios, are increased in AWS patients with DT compared to patients without DT [12]. Interestingly, lymphocyte and platelet levels are conversely significantly lower in DT patients [12].…”

Section: Introductionmentioning

confidence: 99%

“…However, recent evidence suggests the involvement of inflammation in the pathogenesis of alcohol dependence and withdrawal syndrome [9,10]. Increased concentrations of inflammatory biomarkers have been described in both AUD [11] and AWS with and without DT [12]. The number of lymphocytes is known to increase in the blood for both short-term and longterm alcohol consumption.…”

Section: Introductionmentioning

confidence: 99%

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Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens

Melamud,

Bobrik,

Brit

et al. 2024

JCM

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Background: Delirium Tremens (DT) is known to be a serious complication of alcohol withdrawal syndrome (AWS). Neurotransmitter abnormalities, inflammation, and increased permeability are associated with the pathogenesis of AWS and DT. However, the biomarkers of these conditions are still poorly understood. Methods: In this work, biochemical, hematologic, inflammatory, and gut permeability biomarkers were investigated in the following three groups: healthy controls (n = 75), severe AWS patients with DT (n = 28), and mild/moderate AWS without DT (n = 97). Blood sampling was performed after resolution of the acute condition (on 5 ± 1 day after admission) to collect clinical information from patients and to investigate associations with clinical scales. Biomarker analysis was performed using automated analyzers and ELISA. Inflammatory biomarkers included the erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hsCRP), and platelet-to-lymphocyte ratio (PLR). Results: Among the biochemical biomarkers, only glucose, total cholesterol, and alanine aminotransferase (ALT) changed significantly in the analyzed groups. A multiple regression analysis showed that age and ALT were independent predictors of the CIWA-Ar score. Hematologic biomarker analysis showed an increased white blood cell count, and the elevated size and greater size variability of red blood cells and platelets (MCV, RDWc, and PDWc) in two groups of patients. Gut permeability biomarkers (FABP2, LBP, and zonulin) did not change, but were associated with comorbid pathologies (alcohol liver disease and pancreatitis). The increase in inflammatory biomarkers (ESR and PLR) was more evident in AWS patients with DT. Cluster analysis confirmed the existence of a subgroup of patients with evidence of high inflammation, and such a subgroup was more frequent in DT patients. Conclusions: These findings contribute to the understanding of biomarker variability in AWS patients with and without DT and support the heterogeneity of patients by the level of inflammation.

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Section: Blood Biomarkers In Aws Patients With and Without Dtsupporting

confidence: 94%

Section: Blood Biomarkers In Aws Patients With and Without Dtcontrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens

Melamud,

Bobrik,

Brit

et al. 2024

JCM

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Alkol Kullanım Bozukluğunun Detoksifikasyon Tedavisi Sırasında Yoksunluk Şiddeti İle İnflamasyon Parametreleri Arasındaki İlişki ̇

İspir

Tulacı

2024

Bağımlılık Dergisi

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Objective: Alcohol withdrawal is a potentially life-threatening condition that could be seen after discontinuation or a decrease in alcohol consumption. Inflammatory processes take part in alcohol withdrawal duration. This study aimed to investigate the relationship between withdrawal severity and inflammation parameters. Method: This retrospective study was performed via electronic health records in an alcohol and drug treatment center between August-2021 and August-2022. One hundred forty-one inpatients with alcohol use disorder and 134 controls were enrolled. Sociodemographic, clinical, and biochemical data of the participants were collected. Results: The patients and the control group were similar in age, gender, and educational status. The patients’ group had higher levels of neutrophils and lower levels of lymphocytes than the control group. Neutrophil-to-lymphocyte (NLR) and monocyte-to-lymphocyte ratio (MLR) levels were higher in the patients’ group. The alcohol withdrawal severity of patients was positively correlated with NLR levels, MLR levels, the amount of daily alcohol, and years of heavy alcohol consumption. Conclusion: NLR and MLR are inexpensive and easily accessible markers that could be used to estimate alcohol withdrawal severity.

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Neutrophil-lymphocyte ratio as a predictor of delirium tremens in hospitalized patients with alcohol withdrawal

Cited by 2 publications

References 48 publications

Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens

Biochemical, Hematological, Inflammatory, and Gut Permeability Biomarkers in Patients with Alcohol Withdrawal Syndrome with and without Delirium Tremens

Alkol Kullanım Bozukluğunun Detoksifikasyon Tedavisi Sırasında Yoksunluk Şiddeti İle İnflamasyon Parametreleri Arasındaki İlişki ̇

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