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At-Risk Drinking Is Independently Associated With ICU and One-Year Mortality in Critically Ill Nontrauma Patients*

Gacouin, Arnaud MD1,2; Tadie, Jean M. MD, PhD1,2,3; Uhel, Fabrice MD1,2,3; Sauvadet, Elise MD1,3; Fillâtre, Pierre MD1; Letheulle, Julien MD1; Bouju, Pierre MD1; Le Tulzo, Yves MD, PhD1,2,3

doi: 10.1097/CCM.0000000000000041
Clinical Investigations

Objectives: 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.

Design: Observational cohort study.

Setting: A 21-bed mixed ICU in a university hospital.

Patients: A total of 662 patients who experienced an ICU stay of 3 days or more and for whom alcohol consumption could be assessed.

Interventions: None.

Measurements and Main 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.

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.

* See also p. 988.

The authors have disclosed that they do not have any potential conflicts of interest.

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© 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins