Alcohol-related health problems in critically ill patients

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, lecture hall 2. Remote access: https://oulu.zoom.us/j/68410153745

Topic of the dissertation

Alcohol-related health problems in critically ill patients

Doctoral candidate

Medical Doctor Siiri Hietanen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research unit of Surgery, Anesthesiology and Intensive Care

Subject of study

Medicine

Opponent

Docent Stepani Bendel, Kuopio University Hospital

Custos

Professor Janne Liisanantti, University of Oulu / Oulu University Hospital

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Alcohol-related health problems in critically ill patients

High-risk alcohol consumption is a major health problem worldwide. In Finland, 14 % of deaths in the working-age population are caused by alcohol-related diseases. Excessive alcohol consumption predisposes to several acute and chronic diseases in different organ systems often requiring treatment in intensive care units.

The aim of this thesis was to examine the role of high-risk alcohol consumption in critical illness. The thesis consists of four independent studies based on medical records conducted in the district of Oulu University Hospital. The studies included patients treated in intensive care unit for non-traumatic causes, and patients with liver disease. In addition, subjects participating in the Northern Finland Birth Cohort study 1966 and answering 31-years-old questionnaire were included in one study. Another study included victims of sudden death due to alcohol-related heart disease. The studies examined the impact of high-risk alcohol consumption on the need for intensive care, the causes of admission and severity of disease, as well as the outcome of treatment. In sudden cardiac death victims, the coverage of diagnostics and treatment was examined.

The thesis concluded that one third of the patients treated in intensive care unit have a history of high-risk alcohol consumption. These patients had often less severe and partly preventable causes of admission, for example poisonings. In the Northern Finland Birth Cohort study those subjects consuming higher amounts of alcohol at the age of 31 years required intensive care more often later in life. Also, the causes of admission were more often alcohol related compared with other patients.

Nearly 40 % of the patients with liver disease treated in intesive care unit died during the following year. Alcohol consumption did not have a significant impact on the prognosis in these patients, but their cause of death was often alcohol related.

Only one fifth of the victims of sudden death due to alcohol-related heart disease were diagnosed with heart disease during life, although the majority of them were known to have high-risk alcohol consumption.

High-risk alcohol consumption predisposes to the need for intensive care and the proportion of these patients in intensive care is remarkable. High-risk alcohol consumption predisposes to severe diseases, such as liver cirrhosis, and the prognosis is poor especially after intensive care. A significant proportion of alcohol-related heart disease remains undiagnosed pointing out the shortcomings in the screening of alcohol-related diseases. Public health care should focus on screening and preventing alcohol-related diseases in order to prevent alcohol-related morbidity, intensive care resource utilization and mortality.
Last updated: 19.8.2021