Evidence map›Paper›PMID 33270785›Full record

ArticlePloS one2020

Recognition of a disulfiram ethanol reaction in the emergency department is not always straightforward.

Kristof Segher, Liesbeth Huys, Tania Desmet, Evi Steen, Stefanie Chys, Walter Buylaert, Peter De Paepe

Open access · goldAbstract readCase Reports
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Disulfiram-Mitigating Unintended Effects.Antibiotics (Basel, Switzerland) · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Kristof SegherDepartment of Emergency Medicine, AZ Alma, Eeklo, Belgium.
Liesbeth HuysDepartment of Pharmacy, Ghent University Hospital, Ghent, Belgium.
Tania DesmetDepartment of Emergency Medicine, Ghent University Hospital, Ghent, Belgium.ORCID 0000-0003-2337-4411
Evi SteenDepartment of Emergency Medicine, AZ Sint-Jan, Brugge, Belgium.
Stefanie ChysDepartment of Emergency Medicine, Algemeen Stedelijk Ziekenhuis (ASZ), Aalst, Belgium.
Walter BuylaertDepartment of Emergency Medicine, Ghent University Hospital, Ghent, Belgium.
Peter De PaepeDepartment of Emergency Medicine, Ghent University Hospital, Ghent, Belgium.
Ghent University Hospital · BEAlma · BEAZ Sint-Jan · BEOnze Lieve Vrouwziekenhuis Hospital · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDisulfiram is an adjunct in the treatment of alcohol use disorders, but case reports indicate that disulfiram ethanol reactions are not always recognized in the emergency department. Our first aim is to remind of this risk with two case reports of life-threatening reactions not immediately considered by the emergency physician. The second aim is to estimate the probability that a disulfiram reaction goes unrecognized with the use of a retrospective study of patients admitted to the emergency department.

methodsClinical files of patients admitted between October 1, 2010 and September 30, 2014 to the emergency department were retrospectively screened for the key words "ethanol use" and "disulfiram". Their diagnoses were then scored by a panel regarding the probability of an interaction.

resultsSeventy-nine patients were included, and a disulfiram-ethanol reaction was scored as either 'highly likely', 'likely' or 'possible' in 54.4% and as 'doubtful' or 'certainly not present' in 45.6% of the patients. The interrater agreement was 0.71 (95% CI: 0.64-0.79). The diagnosis was not considered or only after a delay in 44.2% of the patients with a 'possible' to 'highly likely' disulfiram interaction. One patient with a disulfiram overdose died and was considered as a 'possible' interaction. DISCUSSION AND

conclusionsA disulfiram ethanol interaction can be life threatening and failure to consider the diagnosis in the emergency department seems frequent. Prospective studies with documentation of the intake of disulfiram and evaluation of the value of acetaldehyde as a biomarker are needed to determine the precise incidence. Improving knowledge of disulfiram interactions and adequate history taking of disulfiram intake may improve the care for patients.

Indexed as

AcetaldehydeAdultAlcohol DeterrentsAlcohol DrinkingAlcoholismDisulfiramDrug InteractionsEmergency Service, HospitalEthanolFemaleHumansMaleMiddle AgedRetrospective StudiesAcetaldehydeAlcohol DeterrentsDisulfiramEthanol

Identifiers

PMID33270785
PMCPMC7714420
OpenAlexW3107193988

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.