Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients.

Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Research Abstract Details 

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Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Abstract Text:

OBJECTIVE: To determine the association between alcohol dependence (alcoholism not in remission and/or alcohol withdrawal) and sepsis, septic shock, and hospital mortality among intensive care unit (ICU) patients. DESIGN: Retrospective cohort study. SETTING: Two ICUs in an urban hospital. PATIENTS: Patients included 11,651 adult admissions to Denver Health Medical Center from January 1, 1999, to December 31, 2004, with >or=1 ICU day. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of first admissions appearing in the data set (n=9,981), 1,222 (12.2%) had a diagnosis consistent with alcohol dependence. These patients had higher rates of sepsis (12.9% vs. 7.6%, p<.001), organ failure (67.3% vs. 45.8%, p<.001), septic shock (3.6% vs. 2.1%, p=.001), and hospital mortality (9.4% vs. 7.5%, p=.022) on unadjusted analyses. Patients with alcohol dependence also had fewer hospital-free days. After adjustment for factors with known association with sepsis, alcohol dependence was associated with sepsis. This association was modified if the patient received (adjusted odds ratio, 0.92; 95% confidence interval, 0.65-1.31) or did not receive (adjusted odds ratio, 1.91; 95% confidence interval, 1.49-2.44) red cell transfusions. A general predisposition to infections mediated some, but not all, of this association. Results were similar when repeat admissions were included in the analysis. Alcohol dependence was also associated with septic shock and hospital mortality in multivariable analyses. Among those with liver disease and sepsis, alcohol dependence was associated with more than two-fold increased risk-adjusted odds of hospital mortality (adjusted odds ration, 2.31; 95% confidence interval, 1.26-4.24). Similarly, sepsis and liver disease carried higher odds of death for alcohol-dependent patients than for those without alcohol dependence. CONCLUSIONS: Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among ICU patients. The underlying mechanisms of this association require exploration, as an increased rate of infections mediated some, but not all, of this association.

Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Publishing Authors By Initials

For similar bacterial infections and mycoses: infection: sepsis: shock, septic research abstracts see: bacterial infections and mycoses: infection: sepsis: shock, septic research

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Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Critical care medicine

VOLUME: 35

Page Numbers: 345-50

Journal Abbreviation: Crit. Care Med.

ISSN: 0090-3493

DAY: 3

MONTH: Feb

YEAR: 2007

Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Information

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LANGUAGE: eng

NlmUniqueID: 355501

Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients. Keywords Mesh Terms:

KEYWORDS: Shock, Septic

MESH TERMS: mortality

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Grant and Affiliation Information for Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients.

AFFILIATION: Ohio State University Medical Center, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Public Health, USA.

Country: United States

AGENCY: United States NHLBI

GRANT: HL70294

ACRONYM: HL

MEDLINETA: Crit Care Med

REFSOURCE: Crit Care Med. 2007 Feb;35(2):627-8

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