The Study
Clinical profile of patients with severe metabolic acidosis in the emergency department of the National Referral Hospital in Bhutan
This study looked at sick people in a hospital and noticed that many who drank alcohol had high levels of a chemical called lactate. But it didn't change anything to test if alcohol caused it — it just watched what happened. So we can say they're linked, but we can't say alcohol made them sick.
Analysis score
Maximum 44 for a cross-sectional study.
Where the score came from
Some people who drink a lot of alcohol get very sick with high acid in their blood, but they often survive—even when their acid levels are higher than most people who die from it.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 543 / 100
Quality score
Snapshots of a population at a single point in time, or descriptions of small groups. Can identify correlations and prevalence, but cannot determine cause and effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1High lactate usually means danger, but in chronic drinkers with acidosis, it doesn't always mean they'll die—so doctors might need to look beyond lactate to judge their risk.
- 2Among 38 very sick patients, 23 had chronic alcohol use: their lactate was 15.7 mmol/L (vs.
- 34.3 in non-drinkers), and 83% survived, compared to 67% of non-drinkers.
- 4Some AKA patients had lactate as high as 17 mmol/L and still survived.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
South Asian Journal of Emergency Medicine
Year
2024
Authors
S. Giri, Sherab Wangdi, Shankar LeVine, Melanie Watts, Ugyen Tshering
Related Content
Claims (6)
In patients with alcoholic ketoacidosis, high blood lactate levels do not reliably indicate whether they will survive to hospital discharge.
In adults with severe metabolic acidosis, those who use alcohol chronically have median lactate levels of 15.7 mmol/L, while those without chronic alcohol use have median lactate levels of 4.3 mmol/L.
In patients with severe metabolic acidosis, those with a history of chronic alcohol use had an 83% survival rate, while those without chronic alcohol use had a 67% survival rate, even though the alcohol-using group had higher lactate levels.
In regions where thiamine deficiency is common, such as Bhutan, doctors routinely give intravenous thiamine to patients with severe metabolic acidosis and suspected alcohol use, even though no controlled studies have proven this treatment works.
When alcohol is consumed and the body is dehydrated, blood becomes more acidic and the body's ability to recover physiologically after consumption is reduced.
In people who drink alcohol heavily over a long time, low levels of thiamine lead to a buildup of lactic acid in the blood due to disrupted energy processing in cells.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.