At-Risk Drinking Is Independently Associated With ICU and One-Year Mortality in Critically Ill Nontrauma Patients

作者：Gacouin Arnaud^*; Tadie Jean M; Uhel Fabrice; Sauvadet Elise; Fillatre Pierre; Letheulle Julien; Bouju Pierre; Le Tulzo Yves

来源：Critical Care Medicine, 2014, 42(4): 860-867.

DOI：10.1097/CCM.0000000000000041

• at-risk drinking
• cohort studies
• intensive care unit
• mortality
• outcomes
• survival analysis

Objectives: The impact of at-risk drinking on the outcomes of nontrauma patients is not well characterized. The aim of this study was to determine whether at-risk drinking is independently associated with the survival of nontrauma patients in an ICU and within 1 year following ICU discharge. %26lt;br%26gt;Design: Observational cohort study. %26lt;br%26gt;Setting: A 21-bed mixed ICU in a university hospital. %26lt;br%26gt;Patients: A total of 662 patients who experienced an ICU stay of 3 days or more and for whom alcohol consumption could be assessed. %26lt;br%26gt;Interventions: None. %26lt;br%26gt;Measurements and Main Results: ICU-related variables were collected prospectively, and a 1-year follow-up was determined retrospectively. Analyses were adjusted based on prognostic determinants of short- and long-term outcomes, as previously described in ICU patients and alcohol abusers. Two hundred and eight patients (33%) were identified as at-risk drinkers according to the National Institute on Alcohol Abuse and Alcoholism criteria. Additionally, 111 patients (17%) died in the ICU, and 97 (15%) died after ICU discharge. From the ICU admission until the end of the 1-year follow-up period, the at-risk drinkers exhibited poorer survival than the non-at-risk drinkers (p = 0.0004, as determined by the log-rank test). More specifically, 50 at-risk drinkers (24%) versus 61 non-at-risk drinkers (13%) died in the ICU (p = 0.0009 for the comparison). After adjustment, at-risk drinking remained independently associated with mortality in the ICU (adjusted odds ratio of 1.83; 95% CI of 1.16-2.89; p = 0.01) and with mortality within the year following ICU discharge (adjusted hazard ratio of 1.70; 95% CI of 1.15-2.52; p = 0.008). The causes of death in the at-risk and non-at-risk drinkers were similar. %26lt;br%26gt;Conclusions: In this population of critically ill nontrauma patients, at-risk drinking was independently associated with death in the ICU and within the year following ICU discharge.

• 出版日期2014-4