title: Do alcohol use disorders impact on long term outcomes from intensive care?
abstract: BACKGROUND
  There is limited evidence regarding the impact of alcohol use disorders on long term outcomes from intensive care. The aims of this study were to analyse the nature and complications of alcohol related admissions to intensive care and determine whether alcohol use disorders impact on survival at six months post ICU discharge.
  
  
  METHODS
  This was an 18 month prospective observational cohort study in a 20 bedded mixed ICU, in a large teaching hospital in Scotland. On admission patients were allocated to one of three alcohol groups: low risk, harmful/hazardous, or alcohol dependency.
  
  
  RESULTS
  34.4% of patients were admitted with an alcohol use disorder. Those with an alcohol related admission (either harmful/hazardous or alcohol dependent) had an increased odds of developing septic shock during their admission, compared with the low risk group (OR 1.67; 95% CI 1.13-2.47, p = 0.01). After adjustment for all lifestyle factors which were significantly different between the groups, alcohol dependence was associated with more than a twofold increased odds of ICU mortality (OR 2.28; 95% CI 1.2-4.69, p = 0.01) and hospital mortality (OR 2.43; 95% CI 1.28-4.621, p = 0.004). After adjustment for deprivation category and age, alcohol dependence was associated with an almost two fold increased odds of mortality at six months post ICU discharge (HR 1.86; CI 1.30-2.70, p = 0.001).
  
  
  CONCLUSIONS
  Alcohol use disorders are a significant risk factor for the development of septic shock in intensive care. Further, alcohol dependency is independently associated with poorer long term outcomes from intensive care.
authors.affiliation: University of Glasgow, School of Medicine, Glasgow Royal Infirmary, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK. joanne.mcpeake@glasgow.ac.uk.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: McPeake
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. Martin.Shaw@nhs.net.
authors.forename: Martin
authors.initials: M
authors.lastname: Shaw
authors.affiliation: University of Glasgow, School of Medicine, Glasgow Royal Infirmary, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK. anna.o'neill@glasgow.ac.uk.
authors.forename: Anna
authors.initials: A
authors.lastname: O'Neill
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. Ewan.Forrest@ggc.scot.nhs.uk.
authors.forename: Ewan
authors.initials: E
authors.lastname: Forrest
authors.affiliation: Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. alex.puxty@nhs.net.
authors.forename: Alex
authors.initials: A
authors.lastname: Puxty
authors.affiliation: University of Glasgow, School of Medicine, Glasgow Royal Infirmary, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK. taraquasim@nhs.net.
authors.forename: Tara
authors.initials: T
authors.lastname: Quasim
authors.affiliation: University of Glasgow, School of Medicine, Glasgow Royal Infirmary, New Lister Building, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK. John.kinsella@glasgow.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Kinsella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019973:Alcohol-Related Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D003422:Critical Care / Q000639:trends*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000639:trends*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult