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Impact of Alcohol Misuse on Requirements for Critical Care Services and Development of Hospital Delirium in Patients With COVID-19 pneumonia.
Jolley, Sarah E; Mowry, Christopher J; Erlandson, Kristine M; Wilson, Melissa P; Burnham, Ellen L.
  • Jolley SE; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Center, Aurora, CO.
  • Mowry CJ; Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO.
  • Erlandson KM; Division of Infectious Diseases, University of Colorado Anschutz Medical Center, Aurora, CO.
  • Wilson MP; Department of Biostatistics, University of Colorado Anschutz Medical Center, Aurora, CO.
  • Burnham EL; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Center, Aurora, CO.
Crit Care Explor ; 5(1): e0829, 2023 Jan.
Article in English | MEDLINE | ID: covidwho-2241882
ABSTRACT
Alcohol misuse has been associated with increased morbidity in the setting of pulmonary infections, including the need for critical care resource utilization and development of delirium. How alcohol misuse impacts morbidity and outcomes among patients admitted with COVID-19 pneumonia is not well described. We sought to determine if alcohol misuse was associated with an increased need for critical care resources and development of delirium among patients hospitalized with COVID-19 pneumonia.

DESIGN:

Retrospective cohort study.

SETTING:

Twelve University of Colorado hospitals between March 2020 and April 2021. PATIENTS Adults with a COVID-19 diagnosis.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

The primary outcome was admission to the ICU. Secondary outcomes included need for mechanical ventilation, development of delirium, and in-hospital mortality. Alcohol misuse was defined by International Classification of Diseases, 10th Revision codes. Of 5,979 patients hospitalized with COVID-19, 26% required ICU admission and 15.4% required mechanical ventilation. Delirium developed in 4.5% and 10.5% died during hospitalization. Alcohol misuse was identified in 4%. In analyses adjusted for age, sex, body mass index, diabetes, and liver disease, alcohol misuse was associated with increased odds of ICU admission (adjusted odds ratio [aOR], 1.46; p < 0.01), mechanical ventilation (aOR, 1.43; p = 0.03), and delirium (aOR, 5.55; p < 0.01) compared with patients without misuse. Mortality rates were not associated with alcohol misuse alone, although the presence of both alcohol misuse and in-hospital delirium significantly increased odds of in-hospital death (aOR, 2.60; p = 0.04).

CONCLUSIONS:

Among patients hospitalized with COVID-19, alcohol misuse was associated with increased utilization of critical care resources including ICU admission and mechanical ventilation. Delirium was an important modifiable risk factor associated with worse outcomes in hospitalized patients with alcohol misuse, including increased odds of death.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2023 Document Type: Article Affiliation country: CCE.0000000000000829

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Journal: Crit Care Explor Year: 2023 Document Type: Article Affiliation country: CCE.0000000000000829