INTERCURRENT COMPLICATIONS IN CHRONIC-ALCOHOLIC MEN ADMITTED TO THE INTENSIVE-CARE UNIT FOLLOWING TRAUMA

Objective: A chronic alcoholic group following trauma was investigated to determine whether their ICU stay was longer than that of a non-alc oholic group and whether their intercurrent complication rate was incr eased. Design. Prospective study. Setting. An intensive care unit. Pat ients. A total of 102 polytraumatized patients were transferred to the ICU after admission to the emergency room and after surgical treatmen t. Of these patients 69 were chronic alcoholics and 33 were allocated to the non-alcoholic group. The chronic-alcoholic group met the DSM-II I-R and ICD-10 criteria for alcohol dependence or chronic alcohol abus e/harmful use. The daily ethanol intake in these patients was greater than or equal to 60 g. Diagnostic indicators included an alcoholism-re lated questionnaire (CAGE), conventional laboratory markers and carboh ydrate-deficient transferrin. Measurement and results. Major intercurr ent complications such as alcohol withdrawal syndrome (AWS), pneumonia , cardiac complications and bleeding disorders were documented and def ined according to internationally accepted criteria. Patients did not differ significantly between groups regarding age, TRISS and APACHE sc ore on admission. The rate of major intercurrent complications was 196 % in the chronic alcoholic vs 70% in the non-alcoholic group (P = 0.00 01). Because of the increased intercurrent complication rate, the ICU stay was significantly prolonged in the chronic-alcoholic group by a m edian period of 9 days. Conclusions. Chronic alcoholics are reported t o have an increased risk of morbidity and mortality. However, to our k nowledge, nothing is known about the morbidity and mortality of chroni c alcoholics in intensive care units following trauma. Since chronic a lcoholics in the ICU develop more major complications with a significa ntly prolonged ICU stay following trauma than non-alcoholics, it seems reasonable to intensify research to identify chronic alcoholics and t o prevent alcohol-related complications.