Three-year mortality among alcoholic patients after intensive care: A population-based cohort study.
Crit Care. 2012 Jan 8;16(1):R5
Authors: Christensen S, Johansen MB, Pedersen L, Jensen R, Larsen KM, Larsson A, Tonnesen E, Christiansen CF, Sorensen HT
ABSTRACT: BACKGROUND: Alcoholic patients comprise a large proportion of patients in intensive care units (ICUs). However, data are limited on the impact of alcoholism on mortality following 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 (e.g., 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 (MRR) using Cox regression analysis, controlling for covariates. RESULTS: A total of 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 non-alcoholic patients. Compared with non-alcoholic patients, the adjusted 30-day MRR was 1.04 (95% confidence interval (CI): 0.87-1.25). Three-year mortality was 36.2% compared with 40.9% among non-alcoholic patients, corresponding to an adjusted 3-year MRR of 1.16 (95% CI: 1.03-1.31). 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 non-alcoholics as the comparator, of 1.64 (95% CI: 1.38-1.95) and 1.67 (95% CI: 1.48-1.90), respectively. CONCLUSION: Alcoholic ICU patients with chronic complications of alcoholism have substantially increased 30-day and three year mortality. In contrast, alcoholics without complications have no increased 30-day and only slightly increased three year mortality.
PMID: 22226344 [PubMed - as supplied by publisher]