PURPOSE: Acute alcohol intoxication (AAI) causes various complications such as electrolyte imbalance, alcoholic ketoacidosis (AKA), rhabdomyolysis, and acute kidney injury (AKI). Although there have been some reports about AKA and rhabdomyolysis, AKI due to acute alcohol intoxication is rarely reported. METHODS: We retrospectively evaluated the medical records of 371 patients with AAI between January 2004 and May 2010 in Uijeongbu St. Mary's Hospital. We compared the clinical findings, morbidity and mortality rate between AKI and normal kidney function (NKF) groups. RESULTS: Of the total 371 patients with AAI, AKI occurred in 107 patients (28.8%). The peak serum creatinine level in AKI patients was 2.9+/-1.9 mg/dL. Thirteen of the 107 patients (12.1%) received renal replacement therapy. AKI group had higher incidence of decreased mentality (29.0% vs 16.3%, p=0.006), dyspnea (11.2% vs 4.9%, p=0.029) and hypotension (66.0% vs 41.7%, p<0.001), and lower incidence of gastrointestinal bleeding (22.4% vs 34.8%, p=0.019), compared to NKF group. The AKI group also had higher incidence of ketoacidosis (78.5% vs 28.8%, p<0.001), rhabdomyolysis (19.6% vs 4.2%, p<0.001), and pneumonia (22.4% vs 8.0%, p<0.001), compared to NKF group. The length of ICU stay was longer (7.4+/-10.8 vs 4.1+/-6.1 days, p=0.003) and the mortality rate was higher (17.8% vs 2.3%, p<0.001) in AKI group. CONCLUSION: This study demonstrated that incidence of AKI in patients with AAI was 28.8% and AKI was associated with high morbidity and mortality. And multivariate analysis demonstrated that independent risk factors of AKI were ketoacidosis and increased serum osmolality.
Acute Kidney Injury ; Alcohol-Induced Disorders ; Alcoholics ; Creatinine ; Dyspnea ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Ketosis ; Kidney ; Medical Records ; Multivariate Analysis ; Osmolar Concentration ; Pneumonia ; Renal Replacement Therapy ; Retrospective Studies ; Rhabdomyolysis ; Risk Factors

OBJECTIVE: To assess the clinical usefulness and diagnostic accuracy of ultrasonographic measurement of endometrial thickness (ET) in women with endometrial hyperplasia or cancer (EH+). METHODS: This retrospective cohort study included 29,995 consecutive women who underwent transvaginal ultrasonography (TVS) for an incidental finding of a thickened endometrium at the health screening and promotion center at Asan Medical Center between 2006 and 2010. Among 959 patients with endometrial abnormalities, 92 patients were included in this study. A total of 867 patients were excluded: 416 were lost to follow-up; 263 did not undergo endometrial biopsy; 155 had endometrial polyps; 17 had submucosal myomas; and 16 had insufficient tissue samples. Endometrial histology was the reference standard for calculating accuracy. RESULTS: Of the 92 patients, 78 (84.8%) had normal pathology, while 14 (15.2%) had endometrial pathology (EH+), including 5 patients (35.7%) with simple hyperplasia without atypia, 3 (21.4%) with complex hyperplasia, and 6 (42.9%) with endometrial carcinoma, all stage Ia. The area under the receiver-operating characteristic curve was 0.75 (95% confidence interval [CI], 0.593–0.906). The cut-off value for ET was 8 mm, indicating that TVS ET had a fair accuracy in diagnosing carcinoma, had a sensitivity of 100% (95% CI, 62.9–100.0%) and a specificity of 24.3% (95% CI, 15.2–36.3%). CONCLUSION: TVS is useful for detecting EH+, with a cut-off value for ET of 8 mm having a high sensitivity for detecting endometrial pathologies and the ability to identify women highly unlikely to have EH+, thereby avoiding more invasive endometrial biopsy.
Biopsy ; Chungcheongnam-do ; Cohort Studies ; Diagnosis ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometrium ; Female ; Humans ; Hyperplasia ; Incidental Findings ; Lost to Follow-Up ; Mass Screening ; Myoma ; Pathology ; Polyps ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography