ISSN: 2577-4301
Authors: Vourch M , Bourdiol A , Thibault M , Volteau C , Zambon O , Nicolet L , Bretonniere C , Guitton C and Brule N
Aims: Unhealthy alcohol use increases morbidity and agitation in the Intensive Care Units (ICU). The consequences of agitation on patients ‘outcome has not been investigated so far. Methods: Impact OH is a prospective observational monoester study. The objectives were to assess the incidence of agitationrelated adverse events (AE) in patients with unhealthy alcohol use and their impact on patients’ outcomes. Results: Data was collected from 159 patients, including 58% males. Main diagnoses on admission were pneumonia (32%) and gastro-intestinal bleeding (26%). Eighty-seven (55%) patients were identified as unhealthy alcohol users. AE occurred in 22/72 (31%) low-risk drinkers vs. 36/87 (42%) unhealthy users (p= 0.2). Compared with low-risk drinkers, AE was noticed in 21/40 (53%) alcohol dependent and 16/28 (57%) heavy alcohol users, mean differences -22, CI 95% [-40.7 ; -3.2], p= 0.01 and -26, CI 95% [-47.8 ; -5.4], p= 0.02, respectively. Patients with vs. without AE spent longer mean (SD) time on ventilator [6.7 (8.3) vs. 1.5 (5.6) days, mean difference -5.2, CI 95% [-7.7 ; -2.7], p< 0.0001] and had more ICU-acquired infections [16 (29%) vs. 2 (2%), mean difference -27, CI 95% [-38.5 ; -14.0], p< 0.0001] without difference in mortality one year after discharge: 9 (16%) vs. 13 (15%), mean difference -1, CI 95% [-13.1 ; 11.5], p=0.9. Conclusion: Alcohol dependent and heavy alcohol users presented more AE than low-risk drinkers which was associated with worse outcome, without difference in mortality one year after discharge. Hence, preventing AE in unhealthy drinkers, regardless of dependence may improve patient’s outcome.
Keywords: Alcohol Use Disorder; Agitation-related adverse events, Intensive Care Unit; Alcohol Withdrawal Syndrome; Alcohol-dependence; Heavy alcohol use
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