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因饮酒导致的 ICU 收治的肝硬化或其他肝病患者的治疗概况和长期预后。

Treatment profile and long-term outcome of intensive care unit-admitted patients with liver cirrhosis or other liver disease in relation to alcohol consumption.

机构信息

Department of Cardiology, Central Osthrobotnian Hospital, Kokkola, Finland.

Department of Anaesthesiology, Medical Research Centre and Research Group of Surgery, Anaesthesia and Intensive Care, University of Oulu, Oulu University Hospital, Oulu, Finland.

出版信息

Scand J Gastroenterol. 2021 Feb;56(2):180-187. doi: 10.1080/00365521.2020.1861646. Epub 2020 Dec 17.

Abstract

OBJECTIVE

To examine the impact of alcohol consumption on the treatment profile, mortality and causes of death in intensive care unit (ICU)-admitted patients with liver cirrhosis and other liver disease.

METHODS

Data on liver disease and ICU treatment of patients with previously diagnosed liver disease between 2015 and 2017 were retrospectively collected from medical records at Oulu University Hospital, Finland. The median follow-up was 367 days. The causes of death were obtained from Statistics Finland.

RESULTS

From 250 patients, high-risk alcohol consumption was present in 74.7% (71 of 95) cirrhotic patients and 43.2% (67 of 155) patients in the other liver disease group. Gastrointestinal causes were the most common admission causes. Despite the higher SOFA scores in the alcoholic liver cirrhosis patients compared with the non-alcoholic cirrhosis, there were no differences in the need for organ support, length of ICU stay or outcome between the groups or the subgroups. There were no differences in 1-year mortality between the cirrhosis groups (alcoholic cirrhosis 43.7% versus non-alcoholic cirrhosis 45.8%,  = 1.0) or between the other liver disease groups (patients with alcohol consumption 37.3% versus patients without alcohol consumption 36.4%,  = 1.0). The patients with high-risk alcohol consumption died more often due to liver disease, whereas the patients without high-risk alcohol consumption died often due to malignancies.

CONCLUSIONS

We report no significant impact of alcohol consumption on the ICU treatment profile or mortality of patients with cirrhosis or other liver disease. The high mortality underlines the importance of preventive measures after ICU admission.

摘要

目的

探讨饮酒对肝硬化和其他肝病患者入住重症监护病房(ICU)的治疗情况、死亡率和死亡原因的影响。

方法

回顾性收集芬兰奥卢大学医院 2015 年至 2017 年期间确诊为肝病的患者的肝脏疾病和 ICU 治疗数据。中位随访时间为 367 天。死亡原因来自芬兰统计局。

结果

在 250 名患者中,74.7%(95 例中的 71 例)肝硬化患者和 43.2%(155 例中的 67 例)其他肝病患者存在高风险饮酒。胃肠道疾病是最常见的入院原因。尽管酒精性肝硬化患者的 SOFA 评分高于非酒精性肝硬化患者,但两组或亚组之间在器官支持需求、ICU 住院时间或结局方面均无差异。肝硬化组(酒精性肝硬化为 43.7%,非酒精性肝硬化为 45.8%,=1.0)或其他肝病组(有饮酒史的患者为 37.3%,无饮酒史的患者为 36.4%,=1.0)之间 1 年死亡率无差异。高风险饮酒患者更多地死于肝病,而无高风险饮酒患者更多地死于恶性肿瘤。

结论

我们报告称,饮酒对肝硬化和其他肝病患者入住 ICU 的治疗情况或死亡率没有显著影响。高死亡率强调了 ICU 入院后预防措施的重要性。

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