Alcoholism and critical illness: A review.
Alcoholism and critical illness: A review.
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DOI：
10.5492/wjccm.v5.i1.27
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发表时间：
2016-02-04
期刊：
影响因子：
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通讯作者：
Mehta, Ashish Jitendra
中科院分区：
文献类型：
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作者：
Mehta, Ashish Jitendra
酒精是世界上最常用和滥用的药物，酒精使用障碍给世界各地的医疗保健系统带来了巨大的负担。在美国，酒精滥用的终生患病率估计约为18%，这些疾病的经济后果是惊人的。对住院患者的研究表明，大约四分之一的重症监护室患者会出现与酒精相关的问题，而不健康的饮酒是重症监护室（ICU）环境中遇到的众多临床问题的原因。酒精使用障碍患者不仅容易出现戒断综合征和其他需要重症监护的疾病，而且与不滥用酒精的类似危重患者相比，他们的并发症发生率更高，ICU和住院时间更长，资源利用率更高，死亡率显着增加。在重症监护环境中观察到的受酒精滥用影响的特定疾病包括谵妄、肺炎、急性呼吸窘迫综合征、败血症、胃肠道出血、创伤和烧伤。尽管在这些环境中酒精引起的疾病负担沉重，但重症监护提供者往往无法识别酒精使用障碍的个体，这可能对这一弱势群体产生重大影响，并延误重要的临床干预措施。
Alcohol is the most commonly used and abused drug in the world, and alcohol use disorders pose a tremendous burden to healthcare systems around the world. The lifetime prevalence of alcohol abuse in the United States is estimated to be around 18%, and the economic consequences of these disorders are staggering. Studies on hospitalized patients demonstrate that about one in four patients admitted to critical care units will have alcohol-related issues, and unhealthy alcohol consumption is responsible for numerous clinical problems encountered in intensive care unit (ICU) settings. Patients with alcohol use disorders are not only predisposed to developing withdrawal syndromes and other conditions that often require intensive care, they also experience a considerably higher rate of complications, longer ICU and hospital length of stay, greater resource utilization, and significantly increased mortality compared to similar critically ill patients who do not abuse alcohol. Specific disorders seen in the critical care setting that are impacted by alcohol abuse include delirium, pneumonia, acute respiratory distress syndrome, sepsis, gastrointestinal hemorrhage, trauma, and burn injuries. Despite the substantial burden of alcohol-induced disease in these settings, critical care providers often fail to identify individuals with alcohol use disorders, which can have significant implications for this vulnerable population and delay important clinical interventions.