Wright, Carly

McAnulty, Greg R

Secombe, Paul

2021-01-28

Alcohol misuse is a disproportionately large contributor to morbidity and mortality in the Northern Territory. A number of alcohol harm minimisation policies have been implemented in recent years. The effect of these on intensive care unit (ICU) admissions has not been fully explored. A retrospective before-after cross-sectional study was conducted at the Alice Springs Hospital ICU between 1 October 2017 and 30 September 2019. The primary outcome was the proportion of admissions in which alcohol misuse was a contributing factor in the 12 months before (pre-reforms phase) versus the 12 months following (post-reforms phase) implementation of alcohol legislation reforms. Secondary outcomes were measures of critical care resource use (length of stay, need for and duration of mechanical ventilation). After exclusions, 1323 ICU admissions were analysed. There was a reduction in the proportion of admissions associated with alcohol misuse between the pre-reforms and post-reforms phases (18.8% versus 11.7%, P < 0.01). This was true for both acute (10.6% versus 3.6%, P < 0.01) and chronic misuse (13.3% versus 9.6%, P = 0.03). Rates of mechanical ventilation were unchanged during the post-reforms phase (18.3% versus 14.7%). Admissions with a primary diagnosis of trauma were lower (10.5% versus 4.7%, P < 0.01). This study demonstrated a reduction in ICU admissions associated with alcohol misuse following the implementation of new alcohol harm minimisation policies. This apparent reduction in alcohol-related harm is suggestive of the effectiveness of the Northern Territory's integrated alcohol harm reduction framework.

Intensive Care Unit, Alice Springs Hospital, Alice Springs, Australia.

School of Medicine, Flinders University, Bedford Park, Australia.

Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Camberwell, Australia.

Anaesth Intensive Care. 2021 Jan 28:310057X20977503. doi: 10.1177/0310057X20977503.

0000-0002-0717-456X

0000-0002-1137-0512

https://pubmed.ncbi.nlm.nih.gov/33508954/?otool=iaurydwlib

https://hdl.handle.net/10137/11643

The effect of alcohol policy on intensive care unit admission patterns in Central Australia: A before-after cross-sectional study.

Journal Article

Publication