The role of chronic alcohol abuse in the development of acute respiratory distress syndrome in adults

被引:316
作者
Moss, M
Bucher, B
Moore, FA
Moore, EE
Parsons, PE
机构
[1] DENVER GEN HOSP,DEPT MED,DENVER,CO 80204
[2] DENVER GEN HOSP,DEPT SURG,DENVER,CO 80204
[3] NATL JEWISH CTR IMMUNOL & RESP MED,DEPT MED,DENVER,CO 80206
[4] NATL JEWISH CTR IMMUNOL & RESP MED,DEPT BIOSTAT,DENVER,CO 80206
[5] UNIV COLORADO,HLTH SCI CTR,DEPT MED,DENVER,CO 80262
[6] UNIV COLORADO,HLTH SCI CTR,DEPT SURG,DENVER,CO 80262
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1996年 / 275卷 / 01期
关键词
D O I
10.1001/jama.275.1.50
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective.-To determine the effect of a history of chronic alcohol abuse on the incidence of acute respiratory distress syndrome (ARDS) and in-hospital mortality. Design.-Prospective cohort study. Patients.-A total of 351 medical and surgical intensive care unit patients with one of seven at-risk diagnoses for the development of ARDS. Main Outcome Measures.-The development of ARDS and in-hospital mortality. Results.-Of the 351 patients enrolled in the study, the incidence of ARDS in patients with a history of alcohol abuse was significantly higher than in patients without a history of alcohol abuse (43% vs 22%) (P<.001; relative risk [RR], 1.98; 95% confidence interval [Cl], 1.32 to 2.85), in patients with sepsis, ARDS developed in 52% of the patients with a prior history of alcohol abuse compared with only 20% in patients without a history of alcohol abuse (P<.001; RR, 2.59; 95% Cl, 1.29 to 5.12). Fifty-one percent (52/102) of the patients who developed ARDS died compared with only 14% (36/249) of patients who did not develop ARDS (P<.001). In the subset of patients who developed ARDS, the in-hospital mortality rate was 65% in patients with a prior history of alcohol abuse. This mortality rate was significantly higher (P=.003) than the mortality rate in patients without a history of alcohol abuse (36%). Conclusions.-A prior history of chronic alcohol abuse significantly increases the risk of developing ARDS in critically ill patients with an identified at-risk diagnosis. Our results may be useful in the earlier and more accurate identification of patients at high risk for developing ARDS.
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页码:50 / 54
页数:5
相关论文
共 26 条
[11]   THE EFFECT OF ACUTE ALCOHOL-INTOXICATION AND CHRONIC ALCOHOL-ABUSE ON OUTCOME FROM TRAUMA [J].
JURKOVICH, GJ ;
RIVARA, FP ;
GURNEY, JG ;
FLIGNER, C ;
RIES, R ;
MUELLER, BA ;
COPASS, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (01) :51-56
[12]  
KELSEY JL, 1986, METHODS OBSERVATIONA, P285
[13]   APACHE-II - A SEVERITY OF DISEASE CLASSIFICATION-SYSTEM [J].
KNAUS, WA ;
DRAPER, EA ;
WAGNER, DP ;
ZIMMERMAN, JE .
CRITICAL CARE MEDICINE, 1985, 13 (10) :818-829
[14]   EFFECT OF END-STAGE LIVER-FAILURE ON THE INCIDENCE AND RESOLUTION OF THE ADULT RESPIRATORY-DISTRESS SYNDROME [J].
MATUSCHAK, GM ;
RINALDO, JE ;
PINSKY, MR ;
GAVALER, JS ;
VANTHIEL, DH .
JOURNAL OF CRITICAL CARE, 1987, 2 (03) :162-173
[15]   EFFECTS OF D-GALACTOSAMINE INDUCED ACUTE LIVER-INJURY ON MORTALITY AND PULMONARY RESPONSES TO ESCHERICHIA-COLI LIPOPOLYSACCHARIDE - MODULATION BY ARACHIDONIC-ACID METABOLITES [J].
MATUSCHAK, GM ;
PINSKY, MR ;
KLEIN, EC ;
VANTHIEL, DH ;
RINALDO, JE .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1990, 141 (05) :1296-1306
[16]   INVALIDATION OF THE APACHE-II SCORING SYSTEM FOR PATIENTS WITH ACUTE TRAUMA [J].
MCANENA, OJ ;
MOORE, FA ;
MOORE, EE ;
MATTOX, KL ;
MARX, JA ;
PEPE, P ;
GREENBURG, AG ;
RUTLEDGE, R ;
CHAMPION, HR .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1992, 33 (04) :504-507
[17]  
MONTGOMERY AB, 1985, AM REV RESPIR DIS, V132, P485
[18]  
MOORE EE, 1981, J TRAUMA, V21, P439
[19]   ESTABLISHING THE RELATIVE ACCURACY OF 3 NEW DEFINITIONS OF THE ADULT-RESPIRATORY-DISTRESS-SYNDROME [J].
MOSS, M ;
GOODMAN, PL ;
HEINIG, M ;
BARKIN, S ;
ACKERSON, L ;
PARSONS, PE .
CRITICAL CARE MEDICINE, 1995, 23 (10) :1629-1637
[20]  
MOSS M, 1994, AM J RESP CRIT CARE, V149, pA417