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Patients With Alcohol Problem Need Mechanical Ventilation

New findings indicate that medical patients with an alcohol-use disorder (AUD) are more likely to require mechanical ventilation, and need it for a longer period of time. More than 300,000 patients receive mechanical ventilation during intensive care per year in the United States, even though the hospital mortality rate for ventilated patients can approach 50 percent.

Mechanical ventilation is associated with a high economic burden, costing a median 32,000 dollars to 56,000 dollars per patient, with younger patients having higher expenses compared to older patients, said Marjolein de Wit, assistant professor of medicine at Virginia Commonwealth University, and corresponding author for the study.

She added that the majority of medical patients with a critical illness have multiple comorbidities such as diabetes, renal failure, heart failure, cirrhosis of the liver, and chronic obstructive lung disease.

These comorbidities make it more difficult to recover from critical illness. Furthermore, said de Wit, certain critical illnesses such as acute respiratory distress syndrome carry a high mortality largely because of limited treatment availability.

In addition, noted de Wit, AUDs are very common in patients who require admission to the intensive-care unit. The rates of AUD are region dependent and thus vary from hospital to hospital, she said. At my institution, we estimate that more than 40 percent of our medical intensive-care unit patients have AUDs. Other researchers have reported a rate of more than 30 percent in their medical intensive-care unit.

De Wit and her colleagues examined data from the Nationwide Inpatient Sample, a large, all-payer inpatient database representing approximately 1,000 hospitals. For this particular study, researchers analyzed all adult patients with one of the six most common diagnoses associated with admission to the intensive-care unit pneumonia, sepsis (severe infections), gas
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