DRINK, DRANK, DRUNK: ALCOHOL WITHDRAWAL anagayle@gmail.com

PE103

DRINK, DRANK, DRUNK: ALCOHOL WITHDRAWAL

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United States

Oral or Poster

Alcohol use disorder (AUD) affects about 18% of the U.S. population. Up to 40% of ICU patients and 16–31% of surgical or trauma patients may develop alcohol withdrawal syndrome (AWS). Early recognition of AWS is critical to reduce morbidity and mortality. However, diagnosis in critically ill patients is challenging due to unreliable histories, sedation, mechanical ventilation, and comorbidities. These factors, along with fragmented care, delay diagnosis and treatment, increasing ICU admissions and complications. Objective biomarkers could support earlier detection.

A targeted literature review examined six studies (2017–2025) assessing phosphatidylethanol (PEth) as a biomarker for recent alcohol use and AWS severity. The studies included observational, retrospective cohort, experimental, and longitudinal designs, with sample sizes from 10 to over 7,000. Populations included AUD patients, psychiatric inpatients, healthy volunteers, and large hospital cohorts. Data extracted covered PEth detectability, its correlation with withdrawal severity, and comparison to traditional biomarkers.

PEth, a direct ethanol metabolite, is detectable up to three weeks after alcohol consumption. Levels <20 ng/mL indicate abstinence; levels >210 ng/mL suggest chronic use. In AUD inpatients (n ≈ 100–200), higher PEth correlated with withdrawal severity. A large retrospective cohort (n ≈ 7,666) found positive PEth linked to recent drinking and increased hospital resource use. Controlled drinking studies confirmed PEth detectability following single drinking episodes.

AWS remains underdiagnosed in critically ill patients. Incorporating PEth testing at intake may improve early detection and prophylactic treatment, reducing complications and ICU readmissions. Further research is needed to define PEth’s predictive value for withdrawal severity.