Clinical Characteristics of Alcoholic Ketoacidosis in Patients with Chronic Alcoholic Ingestion

Kim, Hye Jeong; Yang, Jae Won; Han, Byoung Geun; Lee, Myoung Kyu; Kim, Jae Seok; Yoo, Jong Myoung; Han, Seung Tae; Choi, Jeong Wook; Kim, Min Soo; Choi, Seung Ok

Abstract

BACKGROUND
Alcoholic ketoacidosis is a common disorder observed in chronic alcoholics with metabolic acidosis but there were only several reports. This study was undertaken to evaluate the clinical characteristics of alcoholic ketoacidosis and to identify prognostic factors that could affect survival of patients.
METHODS
We retrospectively evaluated the clinical characteristics and prognostic factors in 66 patients who were diagnosed with alcoholic ketoacidosis.
RESULTS
There were 57 men and 9 women and their mean age was 48.6 years. Duration of alcohol intake was 20+/-12 years. The amount of daily alcohol intake was 129+/-68 g. Alcohol drinking patterns such as duration and the amount of daily alcohol consumption did not differ significantly between the non-survivors the and survivors. On laboratory testing, the levels of creatinine, pCO2, leukocyte count, total bilirubin, creatinine, creatine kinase and lactate dehydrogenase were significantly higher in the non-survivors than in the survivors (respectively, p=0.044; p=0.003; p=0.001; p=0.011; p=0.007; p=0.018). The levels of hemoglobin, total protein, albumin and calcium were significantly lower in the non-survivors than in the survivors (respectively, p=0.003; p=0.022; p=0.001; p= 0.001). Combined conditions on admission were acute renal failure (36/66), alcoholic hepatitis (29/66), gastritis (21/66), rhabdomyolysis (15/66), alcohol withdrawal syndrome (15/66), infections (15/66) and pancreatitis (10/66). Mortality rate was 22.7% (15/66) and common causes of death were uncontrolled acidosis, sepsis and gastrointestinal bleeding.
CONCLUSION
The general conditions, ability of respiratory compensation, renal function and the severity of liver disease on admission were associated with mortality in patients with alcoholic ketoacidosis.