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논문 기본 정보

자료유형
학술저널
저자정보
Colling Kristin P. (Department of Surgery University of Minnesota Medical Center Minneapolis MN USA) Alexandra K. Kraft (Department of Surgery University of Minnesota Medical School Minneapolis MN USA) Harry Melissa L. (Essentia Institute of Rural Health Duluth MN USA)
저널정보
대한중환자의학회 Acute and Critical Care Acute and Critical Care 제38권 제1호
발행연도
2023.2
수록면
122 - 133 (12page)
DOI
10.4266/acc.2022.00584

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Background Alcohol use disorders (AUD) are common in patients admitted to intensive care units (ICU) and increase the risk for worse outcomes. In this study, we describe factors associated with patient mortality after ICU admission and the effect of chemical dependency (CD) counseling on outcomes in the year following ICU admission. Methods We retrospectively reviewed patient demographics, hospital data, and documentation of CD counseling by medical providers for all ICU patients with AUD admitted to our institution between January 2017 and March 2019. Primary outcomes were in-hospital and 1-year mortality. Results Of the 527 patients with AUD requiring ICU care, median age was 56 years (range, 18–86). Both in-hospital (12%) and 1-year mortality rates (27%) were high. Rural patients, comorbidities, older age, need for mechanical ventilation, and complications were associated with increased risk of in-hospital and 1-year mortality. CD counseling was documented for 73% of patients, and 50% of these patients accepted alcohol treatment or resources prior to discharge. CD evaluation and acceptance was associated with a significantly decreased rate of readmission for liver or alcohol-related issues (36% vs. 58%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.27–0.61) and 1-year mortality (7% vs. 19.5%; OR, 0.32; 95% CI, 0.16–0.64). CD evaluation alone, regardless of patient acceptance, was associated with a significantly decreased 1-year post-discharge mortality rate (12% vs. 23%; OR, 0.44; 95% CI, 0.25–0.77). Conclusions ICU patients with AUD had high in-hospital and 1-year mortality. CD evaluation, regardless of patient acceptance, was associated with a significant decrease in 1-year mortality.

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