Hospital Outcomes in Medical Patients With Alcohol-Related and Non- Alcohol-Related Wernicke Encephalopathy

Objective: To conduct a nationwide retrospective cohort study to assess trends and hospitalizationassociated outcomes in patients with Wernicke encephalopathy. Patients and Methods: In this nationwide retrospective cohort study, we used in -hospital claims data of patients hospitalized with Wernicke encephalopathy in Switzerland from January 1, 2012, to December 31, 2020. We estimated incidence rates per 100,000 person -years among the overall Swiss population strati fi ed by alcohol and non - alcohol-induced Wernicke encephalopathy. The primary outcome was all-cause in -hospital mortality. Secondary outcomes included progression to Korsakoff syndrome and 1-year hospital readmission. We estimated odds ratios (ORs) for binary outcomes. Results: It was found that 4098 of 4393 hospitalizations (93.3%) for Wernicke encephalopathy during the 8-year study were alcohol-related. Incidence rates for hospitalizations were 14-fold higher in alcohol-related compared with non - alcohol-related Wernicke encephalopathy (5.43 vs 0.39 per 100,000 person -years). The risk for in -hospital mortality was signi fi cantly lower in patients with alcohol-related vs non - alcohol-related Wernicke encephalopathy (3.2% vs 8.5%; adjusted OR, 0.38; 95% CI, 0.23 to 0.62). Patients with alcohol-related Wernicke encephalopathy had higher risk for development of Korsakoff syndrome (16.9% vs 1.7%; adjusted OR, 10.64; 95% CI, 4.37 to 25.92) and 1-year hospital readmission (31.6% vs 18.7%; adjusted OR, 1.4; 95% CI, 1.04 to 1.88). Conclusion: In this Swiss nationwide cohort study, Wernicke encephalopathy was a rare but serious cause for hospitalization and mainly alcohol-related. Patients with alcohol-related Wernicke encephalopathy had lower risks of in -hospital mortality but were more likely to develop Korsakoff syndrome and be readmitted to the hospital. (c) 2023 THE AUTHORS. Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) center dot Mayo Clin Proc. 2024 ; 99(5):740-753