Intensive Care Unit Alice Springs Hospital, Alice Springs, NT, Australia.
School of Medicine, Flinders University, Bedford Park, SA, Australia.
Addiction. 2021 Oct;116(10):2653-2662. doi: 10.1111/add.15432. Epub 2021 Apr 23.
To describe the effect of alcohol policy on the incidence of intensive care unit (ICU) admissions associated with hazardous and harmful alcohol use in the Northern Territory (NT) of Australia DESIGN, SETTING AND PARTICIPANTS: Before and after analysis of admissions to NT ICUs between April 2018 and September 2019, extending on both a descriptive study describing hazardous and harmful alcohol use and single-centre analyses of harm minimization policies. After exclusions, 2281 (83%) admissions were analysed, 20.3% of which were associated with hazardous and harmful alcohol use.
Primary outcome was the incidence of admissions associated with hazardous and harmful alcohol use in the 5 months preceding (baseline period) the introduction of new alcohol policies [full-time stationing of Police Auxiliary Liquor Inspectors (PALIs) and minimum unit price (MUP)] compared with 12 months (post-intervention) following. Secondary outcomes included measures of resource use [length of stay (LoS), need for mechanical ventilation] and mortality, stratified by site.
Overall, there was a 4.5% [95% confidence interval (CI) = 0.8-8.2%] absolute risk reduction between the time-periods (95% CI = 23.4 versus 18.9% for baseline and post-intervention, respectively, P = 0.01), predominantly due to a reduction in admissions associated with acute misuse (2.3%, 95% CI = -0.2 to 4.9% risk reduction, P = 0.06). There were regional differences, with a more marked relative risk reduction observed in Central Australia compared with the city of Darwin (27.0 versus 16.7% relative risk reduction, respectively).
Introduction of new alcohol harm minimization policies in the Northern Territory of Australia appears to have reduced the number of intensive care unit admissions associated with hazardous and harmful alcohol use. Strength of effect varies by geographical region and chronicity of hazardous and harmful alcohol use.
描述澳大利亚北领地（NT）的酒精政策对与危险和有害酒精使用相关的重症监护病房（ICU）入院的影响。
设计、设置和参与者：在 2018 年 4 月至 2019 年 9 月期间对 NT ICU 入院情况进行描述性研究和单中心伤害最小化政策分析前后进行分析。排除后，分析了 2281 例（83%）入院病例，其中 20.3%与危险和有害酒精使用相关。
主要结局是在新酒精政策（全职派驻警察辅助酒类巡视员（PALIs）和最低单位价格（MUP））引入前的 5 个月内（基线期）与干预后 12 个月内（干预后）与危险和有害酒精使用相关的入院发生率。次要结局包括资源使用（住院时间（LoS）、机械通气需求）和死亡率，按地点分层。
总体而言，两个时间段之间绝对风险降低了 4.5%（95%置信区间（CI）=0.8-8.2%）（95%CI=23.4 与 18.9%，分别为基线和干预后，P=0.01），主要是由于急性滥用相关入院人数减少（2.3%，95%CI=-0.2 至 4.9%风险降低，P=0.06）。存在区域差异，与达尔文市相比，中澳大利亚地区的相对风险降低更为明显（分别为 27.0%和 16.7%）。
在澳大利亚北领地引入新的酒精伤害最小化政策似乎减少了与危险和有害酒精使用相关的 ICU 入院人数。效果的强弱因地理区域和危险和有害酒精使用的慢性程度而异。
