University of Oulu

Hietanen, S., Ala-Kokko, T., Ohtonen, P., Käkelä, R., Niemelä, S., & Liisanantti, J. H. (2017). Treatment Profile and 1-Year Mortality Among Nontraumatic Intensive Care Unit Patients With Alcohol-Related Health Problems. Journal of Intensive Care Medicine, 088506661774007. https://doi.org/10.1177/0885066617740071

Treatment profile and 1-year mortality among nontraumatic intensive care unit patients with alcohol-related health problems

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Author: Hietanen, Siiri1,2; Ala-Kokko, Tero1,2; Ohtonen, Pasi3;
Organizations: 1Division of Intensive Care Medicine, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
2Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, University of Oulu, Oulu, Finland
3Department of Operative Care, Oulu University Hospital, Oulu, Finland
4Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
5Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2019100931977
Language: English
Published: SAGE Publications, 2017
Publish Date: 2019-10-09
Description:

Abstract

Background: Long-term excessive use of alcohol leads to severe complications, which often require treatment in an intensive care unit (ICU). The aim of this study was to report on the associations between alcohol-related health problems and treatment profile, as well as 1-year mortality among patients with nontrauma-related ICU admissions.

Methods: Information on the history of alcohol-related health problems or excessive alcohol use and ICU treatment was collected retrospectively from electronic medical records and ICU patient data management systems at Oulu University Hospital, Finland. Information on 1-year mortality was obtained from the Finnish Population Register Center.

Results: According to the medical records, in a total of 899 admissions, 32.9% (n = 296) of patients had a history of alcohol-related problems. In the alcohol group, intoxications were more frequent and respiratory and cardiovascular causes were less frequent, compared to those without alcohol-related problems. Patients without alcohol-related problems had a higher rate of previous comorbidities compared with the alcohol group. There were no differences concerning age, severity of illness scores, length of stay, or intensive care outcome. Mortality during the 1-year follow-up was 32.8% in total: 35.1% among those without alcohol-related history and 28.0% in the alcohol group (P = .041). The difference in mortality appeared during the first month following admission and remained throughout the follow-up period. The highest 1-year mortality (59.3%) was observed among patients with alcohol-related liver disease.

Conclusion: Every third patient admitted to ICU used alcohol excessively or had alcohol-related diseases, and those patients with alcohol-related liver disease had the poorest 1-year survival rate. We found higher long-term mortality in nonalcohol-related admissions, which can be explained by the case mix, including a lower rate of chronic diseases, such as malignancies and coronary artery disease, and a higher rate of low-risk admission diagnoses in the alcohol group.

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Series: Journal of intensive care medicine
ISSN: 0885-0666
ISSN-E: 1525-1489
ISSN-L: 0885-0666
Volume: In Press
Issue: In Press
Pages: 1 - 15
DOI: 10.1177/0885066617740071
OADOI: https://oadoi.org/10.1177/0885066617740071
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © SAGE Publishing. Reprinted by permission of SAGE Publications. The Definitive Version of Record can be found online at: https://doi.org/10.1177/0885066617740071.