Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Feb 4, 2016; 5(1): 27-35
Published online Feb 4, 2016. doi: 10.5492/wjccm.v5.i1.27
Alcoholism and critical illness: A review
Ashish Jitendra Mehta
Ashish Jitendra Mehta, Division of Pulmonary Critical Care Medicine, Department of Medicine, Atlanta VA Medical Center, Emory University School of Medicine, Atlanta, GA 30322, United States
Author contributions: Mehta AJ contributed to the work in its entirety.
Supported by Ashish J Mehta is supported by a Career Development Award (1IK2CX000643) from the Department of Veterans Affairs (Clinical Science Research and Development).
Conflict-of-interest statement: Author declares no potential conflicts of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashish Jitendra Mehta, MD, MSc, Division of Pulmonary Critical Care Medicine, Department of Medicine, Atlanta VA Medical Center, Emory University School of Medicine, Pulmonary 111, 1670 Clairmont Road, Atlanta, GA 30033, United States. ashish.mehta@emory.edu
Telephone: +1-404-3216111 Fax: +1-404-4171525
Received: July 29, 2015
Peer-review started: July 29, 2015
First decision: September 28, 2015
Revised: October 7, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: February 4, 2016
Processing time: 178 Days and 4.5 Hours
Abstract

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.

Keywords: Alcoholism; Alcohol withdrawal delirium; Alcohol-related disorders critical illness; Intensive care; Pneumonia; Sepsis; Acute respiratory distress syndrome; Delirium; Trauma

Core tip: Alcohol abuse is a major problem among hospitalized patients, and alcoholics are predisposed to developing critical illness while also facing increased rates of complications and mortality compared to non-alcoholics. The objective of this review is to examine the literature and summarize specific disorders encountered in intensive care unit settings that are impacted by alcoholism. Since alcohol use disorders are poorly recognized in hospitalized patients, this effort aims to raise awareness for critical care practitioners who frequently manage these susceptible patients.