Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes alle 43-45, Aarhus N, 8240, Denmark.
Crit Care. 2012 Jan 8;16(1):R5. doi: 10.1186/cc10603.
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.
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.
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.
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.
在重症监护病房（ICU）患者中，酗酒患者占有很大比例。然而，目前关于酗酒对 ICU 后死亡率影响的数据有限。
我们对 2001 年至 2007 年间的 16848 例首次入住 ICU 的患者进行了队列研究，以检查酗酒患者的 30 天和 3 年死亡率。从以前因酗酒相关疾病就诊或戒酒处方配药的住院记录中确定了酗酒且无酒精滥用并发症（如酒精性肝病）和有并发症的酗酒患者。从医疗数据库中获取药物使用、人口统计学、医院诊断和合并症的数据。使用 Cox 回归分析控制协变量，计算 30 天和 3 年死亡率和死亡率比值比（MRR）。
共有 1229 例（7.3%）ICU 患者为当前酗酒者。在无酒精中毒并发症的酗酒患者中（n=785，队列的 4.7%），30 天死亡率为 15.9%，而非酗酒患者为 19.7%。与非酗酒患者相比，调整后的 30 天 MRR 为 1.04（95%置信区间（CI），0.87 至 1.25）。3 年死亡率为 36.2%，而非酗酒患者为 40.9%，相应的调整后 3 年 MRR 为 1.16（95%CI，1.03 至 1.31）。对于有并发症的酗酒患者（n=444，队列的 2.6%），30 天死亡率为 33.6%，3 年死亡率为 64.5%，与非酗酒患者相比，调整后的 MRR 分别为 1.64（95%CI，1.38 至 1.95）和 1.67（95%CI，1.48 至 1.90）。
患有慢性酒精中毒并发症的 ICU 酗酒患者的 30 天和 3 年死亡率显著增加。相比之下，无并发症的酗酒患者 30 天死亡率没有增加，只有 3 年死亡率略有增加。
