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感染患者入院时适量饮酒对 ICU 死亡率的影响。

Impact on ICU mortality of moderate alcohol consumption in patients admitted with infection.

机构信息

CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; Université Rennes1, Faculté de Médecine, Biosit, F-35043 Rennes, France; Inserm-CIC-1414, Faculté de Médecine, Université Rennes I, IFR 140, F-35033 Rennes, France.

CHU Rennes, Maladies Infectieuses et Réanimation Médicale, F-35033 Rennes, France; Université Rennes1, Faculté de Médecine, Biosit, F-35043 Rennes, France.

出版信息

J Crit Care. 2020 Jun;57:91-96. doi: 10.1016/j.jcrc.2020.02.008. Epub 2020 Feb 7.

Abstract

PURPOSE

Alcohol dependence is associated with poor prognosis in the intensive care unit (ICU), but it remains uncertain whether moderate alcohol consumption negatively affects the prognosis of critically ill patients admitted with infection.

MATERIALS AND METHODS

In a prospective observational cohort study performed in 478 patients admitted with documented infection, mortality at day 28 in the group of abstainers and nontrauma patients with estimated alcohol consumption lower than 100 g/week was compared with that in non-alcohol-dependent patients with estimated alcohol consumption between 100 and 350 g/week.

RESULTS

In 97 patients (20%), alcohol consumption was estimated to be over 100 g/week, and in 391 patients (80%), alcohol consumption was estimated to be 100 g/week or less. The pathogens identified did not significantly differ between the two groups of patients. After adjusted analysis, alcohol consumption between 100 and 350 g/week remained significantly associated with mortality at day 28 (hazard ratio (HR): 1.67; 95% confidence interval (CI): 1.01-2.77; p = .04).

CONCLUSION

Alcohol consumption between 100 and 350 g/week was independently associated with mortality at day 28. Our results suggest that in critically ill patients admitted with infection, moderate alcohol consumption is associated with a poorer prognosis.

摘要

目的

酒精依赖与重症监护病房(ICU)的预后不良有关,但目前仍不确定适量饮酒是否会对因感染而住院的危重症患者的预后产生负面影响。

材料和方法

在一项对 478 名确诊感染患者进行的前瞻性观察队列研究中,比较了戒酒组和非创伤性、估计每周饮酒量低于 100g 的患者在 28 天时的死亡率,与估计每周饮酒量在 100-350g 之间的非酒精依赖患者的死亡率。

结果

在 97 名(20%)患者中,估计饮酒量超过 100g/周,在 391 名(80%)患者中,估计饮酒量为 100g/周或更少。两组患者的病原体鉴定没有显著差异。经过调整分析,每周 100-350g 的饮酒量与第 28 天的死亡率仍显著相关(危险比(HR):1.67;95%置信区间(CI):1.01-2.77;p=0.04)。

结论

每周 100-350g 的饮酒量与第 28 天的死亡率独立相关。我们的研究结果表明,在因感染而住院的危重症患者中,适量饮酒与预后不良有关。

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