Purpose: Patients with alcohol-related disease constitute an increasing proportion of those admitted to intensive care
unit. There is currently limited evidence regarding the impact of alcohol use on levels of agitation, delirium and sedative
requirements in intensive care unit. This study aimed to determine whether intensive care unit-admitted alcohol-abuse
patients have different sedative requirements, agitation and delirium levels compared to patients with no alcohol issues.
Methods: This retrospective analysis of a prospectively acquired database (June 2012–May 2013) included 257 patients.
Subjects were stratified into three risk categories: alcohol dependency (n ¼ 69), at risk (n ¼ 60) and low risk (n ¼ 128)
according to Fast Alcohol Screening Test scores and World Health Organisation criteria for alcohol-related disease. Data
on agitation and delirium were collected using validated retrospective chart-screening methods and sedation data were
extracted and then log-transformed to fit the regression model.
Results: Incidence of agitation (p ¼ 0.034) and delirium (p ¼ 0.041) was significantly higher amongst alcohol-dependent
patients compared to low-risk patients as was likelihood of adverse events (p ¼ 0.007). In contrast, at-risk patients were
at no higher risk of these outcomes compared to the low-risk group. Alcohol-dependent patients experienced suboptimal
sedation levels more frequently and received a wider range of sedatives (p ¼ 0.019) but did not receive higher daily
doses of any sedatives.
Conclusions: Our analysis demonstrates that when admitted to intensive care unit, it is those who abuse alcohol most
severely, alcohol-dependent patients, rather than at-risk drinkers who have a significantly increased risk of agitation,
delirium and suboptimal sedation. These patients may require closer assessment and monitoring for these outcomes
whilst admitted
