# Validation of blood-based indices associated with sarcopenia for the prediction of pneumonia and delirium in patients with acute withdrawal from excessive alcohol consumption

## TL;DR

This study found that the AST/ALT blood ratio predicts pneumonia and delirium in patients withdrawing from heavy alcohol use.

## Contribution

The study validates AST/ALT as a predictor of pneumonia and delirium in alcohol withdrawal patients, unlike NLR and PLR.

## Key findings

- Higher AST/ALT ratios were significantly linked to increased pneumonia and delirium risk in alcohol withdrawal patients.
- NLR and PLR showed no association with pneumonia or delirium in this population.
- Adjusting for confounders confirmed AST/ALT's predictive value for both conditions.

## Abstract

This study aimed to explore the hematology-derived relationship between the blood-based indices associated with sarcopenia including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and serum AST/ALT ratio, and the risk of pneumonia and delirium among hospitalized patients experiencing acute withdrawal from excessive alcohol consumption.

For this retrospective study, patients experiencing acute withdrawal from excessive alcohol consumption who underwent inpatient treatment at a psychiatric teaching hospital in western China between January 1, 2014 and December 31, 2023 were analyzed. Patient-related data were accessed through an electronic medical record database, and logistic regression analyses were used to explore the relationship between the blood-based indices associated with sarcopenia and the risk of developing pneumonia and delirium in this population.

This study enrolled 553 patients. The incidence of pneumonia and delirium in this group of patients was 13.74%. AST/ALT ratios were significantly higher in patients with pneumonia relative to non-pneumonia patients (P<0.001) and in those with delirium versus those with no delirium (P<0.01); compared with the low AST/ALT group, the high AST/ALT group had a higher prevalence of pneumonia (21.90% vs. 11.06%, P<0.01) and delirium (20.44% vs. 11.54%, P<0.05). When the AST/ALT was used as a categorical variable, after adjustment for confounding factors, logistic regression showed that the high AST/ALT group had a higher risk of pneumonia (OR = 1.91, 95%CI: 1.09-3.34) and delirium (OR = 1.92, 95%CI: 1.03-3.58) than the low-AST/ALT group. When the AST/ALT were used as continuous variables, after adjustment for potential risk factors, logistic regression showed that higher AST/ALT was associated with a greater risk of both pneumonia and delirium (pneumonia, OR = 1.48, 95%CI: 1.10-2.00; delirium, OR = 1.58, 95%CI: 1.14-2.19). However, NLR and PLR were not associated with a risk of pneumonia and delirium.

These results suggest that in patients with a history of excessive alcohol consumption and hospitalization for acute alcohol withdrawal, the AST/ALT ratio is associated with increased risk of both pneumonia and delirium, while NLR and PLR are not.