Paul Secombe1,2,3,4, Lewis Campbell2,5, Alex Brown6,7, Michael Bailey3, David Pilcher3,4,8. 1. Intensive Care Unit Alice Springs Hospital, Alice Springs, NT. 2. School of Medicine, Flinders University, Bedford Park, SA. 3. Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic. 4. Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, 277 Camberwell Road, Camberwell, Vic. 5. Intensive Care Unit, Royal Darwin Hospital, Darwin, NT. 6. Aboriginal Health Equity, South Australian Health and Medical Research Institute (SAHMRI). 7. Faculty of Health and Medical Sciences, University of Adelaide. 8. Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Vic.
Abstract
BACKGROUND: The Northern Territory (NT) has a long history of heavy alcohol consumption with a correspondingly high attributable morbidity and mortality. AIMS: We aimed to describe the number of admissions to Intensive Care associated with alcohol misuse. METHODS: Prospective case-control study including all admissions to NT Intensive Care Units (ICUs) between 1 July 2018 and 30 June 2019. Characteristics and outcomes of patients who had an admission associated with alcohol misuse (a composite measure of acute and/or chronic misuse) were compared to those who did not. Primary outcome was the number of admissions associated with alcohol misuse. Secondary outcomes included measures of resource use (length of stay (LoS), need for mechanical ventilation) and mortality adjusted for illness severity. RESULTS: Over the sampling period there were 1664 admissions. After exclusions, 1471 admissions were analysed, 307 (21%) of which were associated with alcohol misuse. Acute or chronic misuse was associated with 3.7% and 12.1% of admissions respectively, while 5.1% met criteria for both. Admissions associated with alcohol misuse more frequently required ventilation (38.4% vs 20.7%, p<0.01) and had longer ICU (2.8 vs 2.1 days, p<0.01) and hospital LoS (9.1 vs 7.1 days, p<0.01). There was no difference in hospital mortality (7.2% vs 7.7%, p=0.94), even after adjustment for illness severity, hospital and diagnostic category. CONCLUSIONS: Alcohol misuse is associated with a substantial number of critical care admissions and consume considerable acute care resources. Further policy directed at harm minimisation and epidemiological work at jurisdictional and national level is necessary. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
BACKGROUND: The Northern Territory (NT) has a long history of heavy alcohol consumption with a correspondingly high attributable morbidity and mortality. AIMS: We aimed to describe the number of admissions to Intensive Care associated with alcohol misuse. METHODS: Prospective case-control study including all admissions to NT Intensive Care Units (ICUs) between 1 July 2018 and 30 June 2019. Characteristics and outcomes of patients who had an admission associated with alcohol misuse (a composite measure of acute and/or chronic misuse) were compared to those who did not. Primary outcome was the number of admissions associated with alcohol misuse. Secondary outcomes included measures of resource use (length of stay (LoS), need for mechanical ventilation) and mortality adjusted for illness severity. RESULTS: Over the sampling period there were 1664 admissions. After exclusions, 1471 admissions were analysed, 307 (21%) of which were associated with alcohol misuse. Acute or chronic misuse was associated with 3.7% and 12.1% of admissions respectively, while 5.1% met criteria for both. Admissions associated with alcohol misuse more frequently required ventilation (38.4% vs 20.7%, p<0.01) and had longer ICU (2.8 vs 2.1 days, p<0.01) and hospital LoS (9.1 vs 7.1 days, p<0.01). There was no difference in hospital mortality (7.2% vs 7.7%, p=0.94), even after adjustment for illness severity, hospital and diagnostic category. CONCLUSIONS:Alcohol misuse is associated with a substantial number of critical care admissions and consume considerable acute care resources. Further policy directed at harm minimisation and epidemiological work at jurisdictional and national level is necessary. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Authors: Małgorzata Łowicka-Smolarek; Izabela Kokoszka-Bargieł; Małgorzata Knapik; Konstanty Śmietanka; Piotr Dyrda; Mateusz Możdżeń; Magdalena Kurczab; Jarosław Borkowski; Piotr Knapik Journal: Int J Environ Res Public Health Date: 2022-05-12 Impact factor: 4.614