Three-year mortality among alcoholic patients after intensive care: a population-based cohort study.
BACKGROUND
Alcoholic patients comprise a large proportion of patients in intensive care units (ICUs). However, data are limited on the impact of alcoholism on mortality after intensive care.


METHODS
We conducted a cohort study among 16,848 first-time ICU patients between 2001 and 2007 to examine 30-day and 3-year mortality among alcoholic patients. Alcoholic patients with and without complications of alcohol misuse (for example, alcoholic liver disease) were identified from previous hospital contacts for alcoholism-related conditions or redemption of a prescription for alcohol deterrents. Data on medication use, demographics, hospital diagnoses, and comorbidity were obtained from medical databases. We computed 30-day and 3-year mortality and mortality rate ratios (MRRs) by using Cox regression analysis, controlling for covariates.


RESULTS
In total, 1,229 (7.3%) ICU patients were current alcoholics. Among alcoholic patients without complications of alcoholism (n=785, 4.7% of the cohort), 30-day mortality was 15.9% compared with 19.7% among nonalcoholic patients. Compared with nonalcoholic patients, the adjusted 30-day MRR was 1.04 (95% confidence interval (CI), 0.87 to 1.25). Three-year mortality was 36.2% compared with 40.9% among nonalcoholic patients, corresponding to an adjusted 3-year MRR of 1.16 (95% CI, 1.03 to 1.31). For alcoholic patients with complications (n=444, 2.6% of the cohort), 30-day mortality was 33.6%, and 3-year mortality was 64.5%, corresponding to adjusted MRRs, with nonalcoholics as the comparator, of 1.64 (95% CI, 1.38 to 1.95) and 1.67 (95% CI, 1.48 to 1.90), respectively.


CONCLUSIONS
Alcoholic ICU patients with chronic complications of alcoholism have substantially increased 30-day and 3-year mortality. In contrast, alcoholics without complications have no increased 30-day and only slightly increased 3- year mortality.
Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes alle 43-45, Aarhus N, 8240, Denmark. sc@dce.au.dk
Steffen
S
Christensen
Martin B
MB
Johansen
Lars
L
Pedersen
Reinhold
R
Jensen
Kim M
KM
Larsen
Anders
A
Larsson
Else
E
Tønnesen
Christian F
CF
Christiansen
Henrik T
HT
Sørensen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D003422:Critical Care / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012042:Registries; D055815:Young Adult