WE, an acute reversible complication in chronic alcoholics, can occur in AAIP. Patients often have confusion, ophthalmoparesis, and nystagmus. Identifying potential risk factors can lead to sooner identification and hopefully prevention.

We found 372,860 patients diagnosed with AAIP, of which 785 (0.2%) developed WE. Events of WE were more common in patients who had hypokalemia (aOR 2.131, p<0.01), acidosis (aOR 1.927, p<0.01), hypo-osmolarity/hyponatremia (aOR 1.818, p<0.01),  age≥ 60 years (aOR 1.818, p<0.01), history of alcohol abuse (aOR 5.251, p<0.01) and depression (aOR 2.007, p<0.01), experienced events of acute kidney injury (AKI) (aOR 2.843, p<0.01). While Hispanics showed higher odds of WE compared to Whites (aOR 1.286, p=0.044), no differences were seen between Blacks and Whites (aOR 0.907, p=0.310).  Meanwhile, lower odds of WE were reported among Medicaid-insured patients (vs. Medicare, aOR 0.746, p=0.010) and those with diabetes (aOR 0.697, p<0.01). No differences were seen in females vs. males (aOR 0.932, p=0.387). For AAIP admissions, events of WE led to poorer outcomes with higher mortality than those without events of WE (1.6% vs. 0.2%, aOR 2.616, p<0.01).

Hypokalemia, acidosis, hypo-osmolarity/hyponatremia, age≥ 60 years, events of AKI, history of alcohol abuse, depression, and Hispanic race had higher odds of developing WE. These risk factors will help clinicians anticipate WE in adults presenting with AAIP allowing patients to receive appropriate counseling and prompt interventions to prevent disease progression.