title: At-risk drinking is independently associated with ICU and one-year mortality in critically ill nontrauma patients*.
abstract: OBJECTIVE
  The impact of at-risk drinking on the outcomes of nontrauma patients is not well characterized. The aim of this study was to determine whether at-risk drinking is independently associated with the survival of nontrauma patients in an ICU and within 1 year following ICU discharge.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  A 21-bed mixed ICU in a university hospital.
  
  
  METHODS
  A total of 662 patients who experienced an ICU stay of 3 days or more and for whom alcohol consumption could be assessed.
  
  
  METHODS
  None.
  
  
  RESULTS
  ICU-related variables were collected prospectively, and a 1-year follow-up was determined retrospectively. Analyses were adjusted based on prognostic determinants of short- and long-term outcomes, as previously described in ICU patients and alcohol abusers. Two hundred and eight patients (33%) were identified as at-risk drinkers according to the National Institute on Alcohol Abuse and Alcoholism criteria. Additionally, 111 patients (17%) died in the ICU, and 97 (15%) died after ICU discharge. From the ICU admission until the end of the 1-year follow-up period, the at-risk drinkers exhibited poorer survival than the non-at-risk drinkers (p = 0.0004, as determined by the log-rank test). More specifically, 50 at-risk drinkers (24%) versus 61 non-at-risk drinkers (13%) died in the ICU (p = 0.0009 for the comparison). After adjustment, at-risk drinking remained independently associated with mortality in the ICU (adjusted odds ratio of 1.83; 95% CI of 1.16-2.89; p = 0.01) and with mortality within the year following ICU discharge (adjusted hazard ratio of 1.70; 95% CI of 1.15-2.52; p = 0.008). The causes of death in the at-risk and non-at-risk drinkers were similar.
  
  
  CONCLUSIONS
  In this population of critically ill nontrauma patients, at-risk drinking was independently associated with death in the ICU and within the year following ICU discharge.
authors.affiliation: 1CHU Rennes, Maladies Infectieuses et Réanimation Médicale, Rennes, France. 2Inserm-CIC-0203, Faculté de Médecine, Université Rennes I, IFRI 40, Rennes, France. 3Biosit, Faculté de Médecine, Université Rennes 1, Rennes, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gacouin
authors.forename: Jean M
authors.initials: JM
authors.lastname: Tadie
authors.forename: Fabrice
authors.initials: F
authors.lastname: Uhel
authors.forename: Elise
authors.initials: E
authors.lastname: Sauvadet
authors.forename: Pierre
authors.initials: P
authors.lastname: Fillâtre
authors.forename: Julien
authors.initials: J
authors.lastname: Letheulle
authors.forename: Pierre
authors.initials: P
authors.lastname: Bouju
authors.forename: Yves
authors.initials: Y
authors.lastname: Le Tulzo
mesh_terms: D018806:APACHE; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology* / Q000401:mortality; D002423:Cause of Death; D016638:Critical Illness / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis