Alcohol abuse spills over into critical care resources

By Piriya Mahendra

A quarter of patients admitted to intensive care units (ICUs) in Scotland have alcohol problems, while a fifth have chronic alcohol disease, a survey finds.

Men were significantly more likely than women to be admitted to hospital for alcohol-related matters, at 71.4% versus 50.6%.

And people admitted to an ICU for alcohol-related problems were significantly younger than those who did not have alcohol problems, at a median age of 51 versus 63 years, report Timothy Geary and team in Anaesthesia.

They emphasize that alcohol-related admissions have a significant effect on Scottish ICU services, at an extrapolated cost of £ 8.9 million (€ 11.4 million; USD$ 14.0 million) per year.

"It is very clear that the increased costs identified by our ICU study are part of a much wider problem caused by rising levels of alcohol abuse," Geary commented in a press statement.

His team found that of the 771 admissions to all 24 ICU admissions in Scotland over a 1-month period, 196 (25.4%) were related to alcohol use, 35% were alcohol related, and 22% were related to chronic alcohol use.

Of the 196 patients who were admitted for alcohol-related reasons, 64 (32.7%) had acute intoxication.

There was no significant difference in crude ICU stay and hospital mortality or length of stay between the nonalcohol- and alcohol-related admissions.

However, patients who had been admitted to the ICU for alcohol-related issues had a significantly longer period of ventilation compared with the nonalcohol-related group, at a median duration of 2 days versus 1 day.

Assessment of patients by geographic area ranked by the Scottish Index of Multiple Deprivation (SIMD) showed that those from a worse socioeconomic area were significantly more likely to have an alcohol-related ICU admission than those who were from a less deprived area.

Indeed, 25% of admissions to ICUs in the first SIMD decile, corresponding to the most-deprived area of Scotland, were alcohol related compared with just 2.5% of those in the tenth decile, corresponding to the least-deprived area.

"Alcohol disease adversely affects the outcome of critically ill patients and the burden of this in Scotland is higher than elsewhere in the UK," remarked Geary in a press statement.

"In Scotland, the frequency and volume of alcohol consumed is significantly higher than in the rest of the UK, as is the proportion of people with hazardous drinking habits. This corresponds to higher death rates, particularly for Scottish men, but only indicates a fraction of the deaths attributed to alcohol."

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