A longitudinal investigation of alcohol use over the course of the year following medical-surgical intensive care unit admission

Psychosomatics. 2013 Jul-Aug;54(4):307-16. doi: 10.1016/j.psym.2013.01.003. Epub 2013 Feb 14.


Background: There have been no studies describing post-intensive care unit (ICU) alcohol use among medical-surgical ICU survivors.

Objective: To examine alcohol use and identify potentially modifiable risk factors, such as in-hospital probable acute stress disorder, for increased alcohol use following medical-surgical ICU admission.

Method: This longitudinal investigation included 150 medical-surgical ICU survivors. In-hospital interviews obtained baseline characteristics including pre-ICU alcohol use with the Alcohol Use Disorders Identification Test (AUDIT) and in-hospital probable acute stress disorder with the Post-traumatic Stress Disorder Checklist-civilian version. Clinical factors were obtained from medical records. Post-ICU alcohol use was ascertained via telephone interviews at 3 and 12 months post-discharge using the AUDIT. Mixed-model linear regression was used to examine potential risk factors for increased post-ICU alcohol use.

Results: There was a significant decline in the mean AUDIT score from baseline (3.9, 95% confidence interval [95% CI]: 2.9, 5.0) to 3 months post-ICU (1.5, 95% CI: 1.0, 2.1) (P < 0.001 by one-way analysis of variance [ANOVA]), with a significant increase between 3 and 12 months post-ICU (2.7, 95% CI: 1.8, 3.5) (P < 0.001 by one-way ANOVA). After adjusting for patient and clinical factors, in-hospital probable acute stress disorder (beta: 3.0, 95% CI: 0.9, 5.0) and pre-ICU unhealthy alcohol use (beta: 5.4, 95% CI: 3.4, 7.4) were independently associated with increased post-ICU alcohol use.

Conclusions: Alcohol use decreases in the early aftermath of medical-surgical ICU admission and then increases significantly by one year post-ICU. Interventions for unhealthy alcohol use among medical-surgical ICU survivors that take into account comorbid psychiatric symptoms are needed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alcohol Drinking / epidemiology
  • Alcohol-Related Disorders / epidemiology*
  • Analysis of Variance
  • Critical Care / statistics & numerical data*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Stress Disorders, Traumatic, Acute / epidemiology
  • Surgical Procedures, Operative / rehabilitation
  • Surgical Procedures, Operative / statistics & numerical data*
  • Survivors / statistics & numerical data*