Document Detail


Alcohol screening scores and 90-day outcomes in patients with acute lung injury.
MedLine Citation:
PMID:  23538449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The effects of excess alcohol consumption (alcohol misuse) on outcomes in patients with acute lung injury have been inconsistent, and there are no studies examining this association in the era of low tidal volume ventilation and a fluid conservative strategy. We sought to determine whether validated scores on the Alcohol Use Disorders Identification Test that correspond to past-year abstinence (zone 1), low-risk drinking (zone 2), mild to moderate alcohol misuse (zone 3), and severe alcohol misuse (zone 4) are associated with poor outcomes in patients with acute lung injury.
DESIGN: Secondary analysis.
SETTING: The Acute Respiratory Distress Syndrome Network, a consortium of 12 university centers (44 hospitals) dedicated to the conduct of multicenter clinical trials in patients with acute lung injury.
SUBJECTS: Patients meeting consensus criteria for acute lung injury enrolled in one of three recent Acute Respiratory Distress Syndrome Network clinical trials.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Of 1,133 patients enrolled in one of three Acute Respiratory Distress Syndrome Network studies, 1,037 patients had an Alcohol Use Disorders Identification Test score available for analysis. Alcohol misuse was common with 70 (7%) of patients having Alcohol Use Disorders Identification Test scores in zone 3 and 129 (12%) patients in zone 4. There was a U-shaped association between validated Alcohol Use Disorders Identification Test zones and death or persistent hospitalization at 90 days (34% in zone 1, 26% in zone 2, 27% in zone 3, 36% in zone 4; p < 0.05 for comparison of zone 1 to zone 2 and zone 4 to zone 2). In a multiple logistic regression model, there was a significantly higher odds of death or persistent hospitalization in patients having Alcohol Use Disorders Identification Test zone 4 compared with those in zone 2 (adjusted odds ratio 1.70; 95% confidence interval 1.00, 2.87; p = 0.048).
CONCLUSIONS: Severe but not mild to moderate alcohol misuse is independently associated with an increased risk of death or persistent hospitalization at 90 days in acute lung injury patients.
Authors:
Brendan J Clark; André Williams; Laura M Cecere Feemster; Katharine A Bradley; Madison Macht; Marc Moss; Ellen L Burnham;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  41     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-20     Completed Date:  2013-07-22     Revised Date:  2013-08-09    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1518-25     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Aurora, CO, USA. brendan.clark@ucdenver.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / epidemiology*,  mortality
Adult
Aged
Alcoholism / epidemiology*
Comorbidity
Double-Blind Method
Humans
Logistic Models
Middle Aged
Risk Factors
Tidal Volume
Grant Support
ID/Acronym/Agency:
K24 HL089223/HL/NHLBI NIH HHS; K24-HL-089223/HL/NHLBI NIH HHS; N01HR56167/HR/NHLBI NIH HHS; R24 AA019661/AA/NIAAA NIH HHS; R24-AA-019661-01A1/AA/NIAAA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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