Alcohol related admissions to ICU: an 18 month prospective cohort study

McPeake, J. , Shaw, M., O'Neill, A., Puxty, A., Forrest, E., Quasim, T. and Kinsella, J. (2014) Alcohol related admissions to ICU: an 18 month prospective cohort study. Critical Care Medicine, 42(12), A1459. (doi:10.1097/01.ccm.0000457908.64853.59)

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Publisher's URL: http://dx.doi.org/10.1097/01.ccm.0000457908.64853.59

Abstract

Learning Objectives: Alcohol related admissions to critical care are increasing. However, the impact of alcohol on the ICU journey has not been extensively studied. Further, there is limited evidence regarding the impact on long terms outcomes for patients admitted to critical care with a background of alcohol misuse. This study aimed to explore the impact of alcohol use disorders on the ICU stay and on longer term outcomes.<p></p> Methods: 18 month prospective observational cohort study in a 20 bedded mixed ICU, in a large teaching hospital in Scotland. On admission patients were allocated to one of three alcohol groups: low risk; harmful/hazardous or alcohol dependency.<p></p> Results: 580 ICU patients were screened for the presence of alcohol use disorders during the study period. 34.4% of patients were admitted with a background of alcohol misuse. Those with an alcohol related admission (either the harmful/hazardous or alcohol dependent) had an almost two fold increased odds of developing septic shock during their ICU admission, compared with the low risk group (OR 1.67; 95% CI 1.13-2.47, p=0.01). When adjusted for the presence of liver cirrhosis, the odds of developing septic shock increased even further in those with an alcohol related admission (OR 1.81; 95% CI 1.19-2.76, p=0.005). After adjustment for all lifestyle factors which were significantly different between the groups, alcohol dependence was associated with more than a twofold increased odds of ICU mortality (OR 2.28; 95% CI 1.2-4.69, p=0.01) and hospital mortality (OR 2.43; 95% CI 1.28-4.621, p=0.004). After adjustment for the presence of septic shock during the ICU admission, age and APACHE II, alcohol dependence was independently associated with mortality at six months post ICU discharge (HR 1.50; 95% CI 1.02-2.22, p= 0.0387).<p></p> Conclusions: Alcohol related admissions account for a significant proportion of admissions to critical care. Alcohol use disorders are a significant risk factor for the development of septic shock in ICU. Further, alcohol dependency is independently associated with ICU, hospital and 6 month outcomes.<p></p>

Item Type:Articles
Additional Information:44th Critical Care Congress, Society of Critical Care Medicine, Phoenix, AZ, USA, 17-21 January 2015
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quasim, Dr Tara and Kinsella, Professor John and O'Neill, Dr Anna and Forrest, Dr Ewan and Shaw, Mr Martin and McPeake, Dr Joanne
Authors: McPeake, J., Shaw, M., O'Neill, A., Puxty, A., Forrest, E., Quasim, T., and Kinsella, J.
Subjects:R Medicine > R Medicine (General)
R Medicine > RT Nursing
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Journal Name:Critical Care Medicine
Publisher:Lippincott, Williams and Wilkins
ISSN:0090-3493
ISSN (Online):1530-0293
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