The role of chronic alcohol abuse in the development of acute respiratory distress syndrome in adults.
OBJECTIVE
To determine the effect of a history of chronic alcohol abuse on the incidence of acute respiratory distress syndrome (ARDS) and in-hospital mortality.


METHODS
Prospective cohort study.


METHODS
A total of 351 medical and surgical intensive care unit patients with one of seven at-risk diagnoses for the development of ARDS.


METHODS
The development of ARDS and in-hospital mortality.


RESULTS
Of the 351 patients enrolled in the study, the incidence of ARDS in patients with a history of alcohol abuse was significantly higher than in patients without a history of alcohol abuse (43% vs 22%) (P < .001; relative risk [RR], 1.98; 95% confidence interval [Cl], 1.32 to 2.85). In patients with sepsis, ARDS developed in 52% of the patients with a prior history of alcohol abuse compared with only 20% in patients without a history of alcohol abuse (P < .001; RR, 2.59; 95% Cl, 1.29 to 5.12). Fifty-one percent (52/102) of the patients who developed ARDS died compared with only 14% (36/249) of patients who did not develop ARDS (P < .001). In the subset of patients who developed ARDS, the in-hospital mortality rate was 65% in patients with a prior history of alcohol abuse. This mortality rate was significantly higher (P = .003) than the mortality rate in patients without a history of alcohol abuse (36%).


CONCLUSIONS
A prior history of chronic alcohol abuse significantly increases the risk of developing ARDS in critically ill patients with an identified at-risk diagnosis. Our results may be useful in the earlier and more accurate identification of patients at high risk for developing ARDS.
Department of Medicine, Denver (Colo) General Hospital.
M
M
Moss
B
B
Bucher
F A
FA
Moore
E E
EE
Moore
P E
PE
Parsons
D018806:APACHE; D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000401:mortality; D000704:Analysis of Variance; D016638:Critical Illness / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate