Three-year mortality among alcoholic patients after intensive care a population-based cohort study 英文参考文献.docVIP

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Three-year mortality among alcoholic patients after intensive care a population-based cohort study 英文参考文献.doc

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Three-year mortality among alcoholic patients after intensive care a population-based cohort study 英文参考文献

Christensenetal.CriticalCare2012,16:R5 /content/16/1/R5 RESEARCH OpenAccess Three-yearmortalityamongalcoholicpatients afterintensivecare:apopulation-basedcohort study SteffenChristensen1*,MartinBJohansen1,LarsPedersen1,ReinholdJensen2,KimMLarsen3,AndersLarsson4, ElseT?nnesen3,ChristianFChristiansen1andHenrikTS?rensen1,5 Abstract Introduction:Alcoholicpatientscomprisealargeproportionofpatientsinintensivecareunits(ICUs).However, dataarelimitedontheimpactofalcoholismonmortalityafterintensivecare. Methods:Weconductedacohortstudyamong16,848first-timeICUpatientsbetween2001and2007toexamine 30-dayand3-yearmortalityamongalcoholicpatients.Alcoholicpatientswithandwithoutcomplicationsofalcohol misuse(forexample,alcoholicliverdisease)wereidentifiedfromprevioushospitalcontactsforalcoholism-related conditionsorredemptionofaprescriptionforalcoholdeterrents.Dataonmedicationuse,demographics,hospital diagnoses,andcomorbiditywereobtainedfrommedicaldatabases.Wecomputed30-dayand3-yearmortalityand mortalityrateratios(MRRs)byusingCoxregressionanalysis,controllingforcovariates. Results:Intotal,1,229(7.3%)ICUpatientswerecurrentalcoholics.Amongalcoholicpatientswithoutcomplications ofalcoholism(n=785,4.7%ofthecohort),30-daymortalitywas15.9%comparedwith19.7%amongnonalcoholic patients.Comparedwithnonalcoholicpatients,theadjusted30-dayMRRwas1.04(95%confidenceinterval(CI), 0.87to1.25).Three-yearmortalitywas36.2%comparedwith40.9%amongnonalcoholicpatients,correspondingto anadjusted3-yearMRRof1.16(95%CI,1.03to1.31).Foralcoholicpatientswithcomplications(n=444,2.6%of thecohort),30-daymortalitywas33.6%,and3-yearmortalitywas64.5%,correspondingtoadjustedMRRs,with nonalcoholicsasthecomparator,of1.64(95%CI,1.38to1.95)and1.67(95%CI,1.48to1.90),respectively. Conclusions:AlcoholicICUpatientswithchroniccomplicationsofalcoholismhavesubstantiallyincreased30-day and3-yearmortality.Incontrast,alcoholicswithoutcomplicationshavenoincreased30-dayandonlyslightly increased3-yearmortality. Introduction with definite al