{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:20:21Z","timestamp":1760660421304,"version":"build-2065373602"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The paucity of research linking thiamine treatment with improved outcomes may be driving its underutilization among patients at risk for Wernicke encephalopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess relationships of thiamine usage to outcomes of patients hospitalized with alcohol use disorder and pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting\u00a0and\u00a0Participants<\/jats:title><jats:p>This is a retrospective cohort study of adult patients hospitalized with pneumonia who also have alcohol use disorder and were treated with benzodiazepines during the initial two hospital days, between 2010 and 2015 at hospitals participating in the Premier Healthcare Database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Exposure<\/jats:title><jats:p>Any thiamine treatment, and, among those treated, high\u2010dose thiamine treatment, during the initial two hospital days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome and Measures<\/jats:title><jats:p>Death on days 3\u201314 of hospitalization (primary); discharge home; transfer to intensive care unit; length of stay (LOS). We used propensity\u2010weighted models to estimate treatment effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 36,732 patients from 625 hospitals, 26,520 (72.2%) patients received thiamine, with mortality of 6.5% and 8.1% among recipients and nonrecipients, respectively. With propensity score adjustment, thiamine was associated with reduced mortality (odds ratio [OR]: 0.80, 95% confidence interval [CI]:\u00a00.75\u20130.85) and more frequent discharges to home (OR: 1.10, 95% CI: 1.06\u20131.14). Other outcomes were similar. Relative to low\u2010dose thiamine, high\u2010dose thiamine was not associated with mortality (adjusted OR: 0.99, 95% CI: 0.89\u20131.10), but LOS was longer (ratio of means: 1.06, 95% CI: 1.04\u20131.08), and discharges to home were less frequent (OR: 0.92, 95% CI: 0.87\u20130.97).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Thiamine is not reliably given to patients with pneumonia and alcohol use disorder receiving benzodiazepines. Improving thiamine administration may represent an opportunity to save lives in this high\u2010risk group of inpatients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.12895","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T01:14:56Z","timestamp":1655860496000},"page":"585-593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early treatment with thiamine and mortality among patients with alcohol use disorder who are hospitalized for pneumonia"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5714-3139","authenticated-orcid":false,"given":"Sarah W.","family":"Baron","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Chun","family":"Yu","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter B.","family":"Imrey","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Cleveland Clinic  Cleveland Ohio USA"},{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William N.","family":"Southern","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hospital Medicine Montefiore Medical Center and Albert Einstein College of Medicine Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Center for Value\u2010Based Care Research, Cleveland Clinical Community Care, Cleveland Clinic Cleveland Ohio USA"},{"name":"Department of Infectious Diseases Respiratory Institute, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-1876","authenticated-orcid":false,"given":"Michael B.","family":"Rothberg","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland Ohio USA"},{"name":"Center for Value\u2010Based Care Research, Cleveland Clinical Community Care, Cleveland Clinic Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Substance Abuse and Mental Health Services Administration. 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