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Comparing Outcomes and Infection Risk in Medical, Surgical, and Trauma Intensive Care Patients with Alcohol Use

Kristin P Colling1, Alexandra K Kraft2, Melissa L Harry3

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Patients with alcohol use disorder (AUD) in intensive care units (ICUs) face high infection rates and mortality. Infections independently predict mortality in ICU patients with AUD, especially those with septic shock.

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alcohol use disordercritical illnessinfectionmortalitysurgerytrauma

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Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Addiction Medicine

Background:

  • Alcohol use disorder (AUD) is a prevalent comorbidity in intensive care units (ICUs).
  • Understanding the impact of AUD on ICU patient outcomes is crucial for effective management.

Purpose of the Study:

  • To evaluate the association between AUD and infection rates, morbidity, and mortality in medical, surgical, and trauma ICUs.
  • To identify infection as an independent predictor of mortality in ICU patients with AUD.

Main Methods:

  • Retrospective chart review of 527 ICU patients with AUD diagnoses.
  • Comparison of demographics, hospital course, infection types, and mortality across ICU types.
  • Multivariable analysis to control for confounding factors and assess infection's predictive value.

Main Results:

  • Infections occurred in 40% of ICU patients with AUD, with no difference in rates across ICU types.
  • Infection was an independent predictor of in-hospital mortality (aOR 3.3).
  • Septic shock, occurring in 57% of infections, significantly increased mortality risk (38% vs. 2%).

Conclusions:

  • AUD is associated with substantial infection burden and high morbidity/mortality in all ICU settings.
  • Infections represent a critical independent risk factor for mortality in ICU patients with AUD.
  • Targeted infection prevention and management strategies are essential for this patient population.