Clark Brendan J, Rubinsky Anna D, Ho P Michael, Au David H, Chavez Laura J, Moss Marc, Bradley Katharine A
a Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado , Aurora , Colorado , USA.
b Center of Excellence for Substance Abuse Treatment and Education , Department of Veterans Affairs Puget Sound Health Care System , Seattle , Washington , USA.
Subst Abus. 2016 Jul-Sep;37(3):466-473. doi: 10.1080/08897077.2015.1137259. Epub 2016 Jan 5.
The association between alcohol misuse and the need for intensive care unit admission as well as hospital readmission among those discharged from the hospital following a critical illness is unclear. This study sought to determine whether alcohol misuse was associated with (1) admission to an intensive care unit (ICU) among a cohort of patients receiving outpatient care and (2) hospital readmission among those discharged from the hospital following critical illness.
This was a retrospective cohort study conducted with data from 24 Veterans Affairs (VA) health care facilities between 2004 and 2007. Scores on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire were used to identify patients with past-year abstinence, lower-risk alcohol use, moderate alcohol misuse, or severe alcohol misuse. The primary outcome was admission to a VA intensive care unit within the year following administration of the AUDIT-C. In an analysis focused on patients discharged from the ICU, the 2 main outcomes were hospital readmission within 1 year and within 30 days.
Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0% (95% confidence interval [CI]: 1.7%-2.3%) for abstinent patients, 1.6% (95% CI: 1.3%-1.8%) for patients with lower-risk alcohol use, 1.8% (1.4%-2.3%) for patients with moderate alcohol misuse, and 2.5% (2.0%-2.9%) for patients with severe alcohol misuse. Among the 9,030 patients discharged from an ICU, the adjusted probability of hospital readmission within 1 year was 48% (46%-49%) in abstinent patients, 44% (42%-45%) in patients with lower-risk alcohol use, 42% (39%-45%) in patients with moderate alcohol misuse, and 55% (49%-60%) in patients with severe alcohol misuse.
Alcohol misuse may represent a modifiable risk factor for a cycle of ICU admission and subsequent hospital readmission.
酒精滥用与重症监护病房收治需求以及危重症出院患者再次入院之间的关联尚不清楚。本研究旨在确定酒精滥用是否与以下情况相关：（1）接受门诊治疗的一组患者入住重症监护病房（ICU）；（2）危重症出院患者再次入院。
这是一项回顾性队列研究，使用了2004年至2007年期间24家退伍军人事务部（VA）医疗保健机构的数据。酒精使用障碍识别测试-消费版（AUDIT-C）问卷得分用于识别过去一年戒酒、低风险饮酒、中度酒精滥用或重度酒精滥用的患者。主要结局是在进行AUDIT-C评估后的一年内入住VA重症监护病房。在一项针对从ICU出院患者的分析中，两个主要结局是1年内和30天内再次入院。
在486,115名接受门诊治疗的退伍军人中，戒酒患者1年内入住ICU的校正概率为2.0%（95%置信区间[CI]：1.7%-2.3%），低风险饮酒患者为1.6%（95%CI：1.3%-1.8%），中度酒精滥用患者为1.8%（1.4%-2.3%），重度酒精滥用患者为2.5%（2.0%-2.9%）。在9,030名从ICU出院的患者中，戒酒患者1年内再次入院的校正概率为48%（46%-49%），低风险饮酒患者为44%（42%-45%），中度酒精滥用患者为4
