Spies C D, Neuner B, Neumann T, Blum S, Müller C, Rommelspacher H, Rieger A, Sanft C, Specht M, Hannemann L, Striebel H W, Schaffartzik W
Klinik für Anaesthesiologie und Operative Intensivmedizin, Universitaetsklinikum Benjamin Franklin, Freie Universität Berlin, Germany.
Intensive Care Med. 1996 Apr;22(4):286-93. doi: 10.1007/BF01700448.
A chronic alcoholic group following trauma was investigated to determine whether their ICU stay was longer than that of a non-alcoholic group and whether their intercurrent complication rate was increased.
Prospective study.
An intensive care unit.
A total of 102 polytraumatized patients were transferred to the ICU after admission to the emergency room and after surgical treatment. Of these patients 69 were chronic alcoholics and 33 were allocated to the non-alcoholic group. The chronic-alcoholic group. met the DSM-III-R and ICD-10 criteria for alcohol dependence or chronic alcohol abuse/harmful use. The daily ethanol intake in these patients was > or = 60 g. Diagnostic indicators included an alcoholism-related questionnaire (CAGE), conventional laboratory markers and carbohydrate-deficient transferrin.
Major intercurrent complications such as alcohol withdrawal syndrome (AWS), pneumonia, cardiac complications and bleeding disorders were documented and defined according to internationally accepted criteria. Patients did not differ significantly between groups regarding age, TRISS and APACHE score on admission. The rate of major intercurrent complications was 196% in the chronic alcoholic vs 70% in the non-alcoholic group (p = 0.0001). Because of the increased intercurrent complication rate, the ICU stay was significantly prolonged in the chronic-alcoholic group by a median period of 9 days.
Chronic alcoholics are reported to have an increased risk of morbidity and mortality. However, to our knowledge, nothing is known about the morbidity and mortality of chronic alcoholics in intensive care units following trauma. Since chronic alcoholics in the ICU develop more major complications with a significantly prolonged ICU stay following trauma than non-alcoholics, it seems reasonable to intensify research to identify chronic alcoholics and to prevent alcohol-related complications.
对创伤后慢性酒精中毒组进行调查，以确定其在重症监护病房（ICU）的住院时间是否长于非酒精中毒组，以及其并发并发症的发生率是否增加。
前瞻性研究。
一家重症监护病房。
共有102例多发伤患者在急诊室入院并接受手术治疗后被转入ICU。其中69例为慢性酒精中毒患者，33例被分配到非酒精中毒组。慢性酒精中毒组符合美国精神疾病诊断与统计手册第三版修订版（DSM-III-R）和国际疾病分类第十版（ICD-10）中酒精依赖或慢性酒精滥用/有害使用的标准。这些患者的每日乙醇摄入量≥60克。诊断指标包括一份与酒精中毒相关的问卷（CAGE）、传统实验室指标和缺糖转铁蛋白。
记录了诸如酒精戒断综合征（AWS）、肺炎、心脏并发症和出血性疾病等主要并发并发症，并根据国际公认的标准进行定义。两组患者在年龄、创伤严重度特征评分（TRISS）和入院时的急性生理与慢性健康状况评分系统（APACHE）评分方面无显著差异。慢性酒精中毒组的主要并发并发症发生率为196%，而非酒精中毒组为70%（p = 0.0001）。由于并发并发症发生率增加，慢性酒精中毒组在ICU的住院时间显著延长，中位数延长了9天。
据报道，慢性酒精中毒患者的发病和死亡风险增加。然而，据我们所知，对于创伤后入住重症监护病房的慢性酒精中毒患者的发病和死亡率尚无了解。由于与非酒精中毒患者相比，ICU中的慢性酒精中毒患者在创伤后会出现更多的主要并发症，且ICU住院时间显著延长，因此加强研究以识别慢性酒精中毒患者并预防与酒精相关的并发症似乎是合理的。
