title: A longitudinal investigation of alcohol use over the course of the year following medical-surgical intensive care unit admission.
abstract: BACKGROUND
  There have been no studies describing post-intensive care unit (ICU) alcohol use among medical-surgical ICU survivors.
  
  
  OBJECTIVE
  To examine alcohol use and identify potentially modifiable risk factors, such as in-hospital probable acute stress disorder, for increased alcohol use following medical-surgical ICU admission.
  
  
  METHODS
  This longitudinal investigation included 150 medical-surgical ICU survivors. In-hospital interviews obtained baseline characteristics including pre-ICU alcohol use with the Alcohol Use Disorders Identification Test (AUDIT) and in-hospital probable acute stress disorder with the Post-traumatic Stress Disorder Checklist-civilian version. Clinical factors were obtained from medical records. Post-ICU alcohol use was ascertained via telephone interviews at 3 and 12 months post-discharge using the AUDIT. Mixed-model linear regression was used to examine potential risk factors for increased post-ICU alcohol use.
  
  
  RESULTS
  There was a significant decline in the mean AUDIT score from baseline (3.9, 95% confidence interval [95% CI]: 2.9, 5.0) to 3 months post-ICU (1.5, 95% CI: 1.0, 2.1) (P < 0.001 by one-way analysis of variance [ANOVA]), with a significant increase between 3 and 12 months post-ICU (2.7, 95% CI: 1.8, 3.5) (P < 0.001 by one-way ANOVA). After adjusting for patient and clinical factors, in-hospital probable acute stress disorder (beta: 3.0, 95% CI: 0.9, 5.0) and pre-ICU unhealthy alcohol use (beta: 5.4, 95% CI: 3.4, 7.4) were independently associated with increased post-ICU alcohol use.
  
  
  CONCLUSIONS
  Alcohol use decreases in the early aftermath of medical-surgical ICU admission and then increases significantly by one year post-ICU. Interventions for unhealthy alcohol use among medical-surgical ICU survivors that take into account comorbid psychiatric symptoms are needed.
authors: Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98104, USA. ddavydo1@u.washington.edu
authors: Dimitry S
authors: DS
authors: Davydow
authors: Douglas
authors: D
authors: Zatzick
authors: Catherine L
authors: CL
authors: Hough
authors: Wayne J
authors: WJ
authors: Katon
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D000704:Analysis of Variance; D003422:Critical Care / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D040701:Stress Disorders, Traumatic, Acute / Q000453:epidemiology; D013514:Surgical Procedures, Operative / Q000534:rehabilitation / Q000706:statistics & numerical data*; D017741:Survivors / Q000706:statistics & numerical data*