Three-year mortality among alcoholic patients after intensive care: a population-based cohort study.

Abstract

INTRODUCTION:

Alcoholic patients comprise a large proportion of patients in intensive care units (ICUs). However, data are limited on the impact of alcoholism on mortality after intensive care.

METHODS:

We conducted a cohort study among 16,848 first-time ICU patients between 2001 and 2007 to examine 30-day and 3-year mortality among alcoholic patients. Alcoholic patients with and without complications of alcohol misuse (for example, alcoholic liver disease) were identified from previous hospital contacts for alcoholism-related conditions or redemption of a prescription for alcohol deterrents. Data on medication use, demographics, hospital diagnoses, and comorbidity were obtained from medical databases. We computed 30-day and 3-year mortality and mortality rate ratios (MRRs) by using Cox regression analysis, controlling for covariates.

RESULTS:

In total, 1,229 (7.3%) ICU patients were current alcoholics. Among alcoholic patients without complications of alcoholism (n=785, 4.7% of the cohort), 30-day mortality was 15.9% compared with 19.7% among nonalcoholic patients. Compared with nonalcoholic patients, the adjusted 30-day MRR was 1.04 (95% confidence interval (CI), 0.87 to 1.25). Three-year mortality was 36.2% compared with 40.9% among nonalcoholic patients, corresponding to an adjusted 3-year MRR of 1.16 (95% CI, 1.03 to 1.31). For alcoholic patients with complications (n=444, 2.6% of the cohort), 30-day mortality was 33.6%, and 3-year mortality was 64.5%, corresponding to adjusted MRRs, with nonalcoholics as the comparator, of 1.64 (95% CI, 1.38 to 1.95) and 1.67 (95% CI, 1.48 to 1.90), respectively.

CONCLUSIONS:

Alcoholic ICU patients with chronic complications of alcoholism have substantially increased 30-day and 3-year mortality. In contrast, alcoholics without complications have no increased 30-day and only slightly increased 3- year mortality.

• Authors: Steffen Christensen, Martin B Johansen, Lars Pedersen, Reinhold Jensen, Kim M Larsen, Anders Larsson, Else Tønnesen, Christian F Christiansen, Henrik T Sørensen
• Journal: Critical care (London, England) (Crit Care) Vol. 16 Issue 1 Pg. R5 (Jan 08 2012) ISSN: 1466-609X [Electronic] England
• PMID: 22226344 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Alcoholism (mortality, therapy)
• Cohort Studies
• Critical Care (trends)
• Female
• Humans
• Male
• Middle Aged
• Population Surveillance (methods)
• Prospective Studies
• Registries
• Young Adult