PDF(Pubmed)
Abstract：
Screening for hazardous alcohol use and performing brief interventions (BIs) are recommended to reduce alcohol-related negative health consequences. We aimed to compare the effectiveness (defined as an at least 10% absolute difference) of BI with usual care in reducing alcohol intake in intensive care unit survivors with history of hazardous alcohol use.
We used Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess history of alcohol use.
Emergency admitted adult ICU patients in three Finnish university hospitals, with an AUDIT-C score > 5 (women), or > 6 (men). We randomized consenting eligible patients to receive a BI or treatment as usual (TAU).
BI was delivered by the time of ICU discharge or shortly thereafter in the hospital ward.
Control patients received TAU.
The primary outcome was self-reported alcohol consumption during the preceding week 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality. The trial was terminated early due to slow recruitment during the pandemic.
We randomized 234 patients to receive BI (N = 117) or TAU (N = 117). At 6 months, the median alcohol intake in the BI and TAU groups were 6.5 g (interquartile range [IQR] 0-141) and 0 g (0-72), respectively (p = 0.544). At 12 months, it was 24 g (0-146) and 0 g (0-96) in the BI and TAU groups, respectively (p = 0.157). Median change in AUDIT-C from baseline to 6 months was - 1 (- 4 to 0) and 2 (- 6 to 0), (p = 0.144) in the BI and TAU groups, and to 12 months - 3 (- 5 to - 1) and - 4 (- 7 to - 1), respectively (p = 0.187). In total, 4% (n = 5) of patients in the BI group and 11% (n = 13) of patients in the TAU group were abstinent at 6 months, and 10% (n = 12) and 15% (n = 17), respectively, at 12 months. No between-groups difference in mortality emerged.
As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption.
ClinicalTrials.gov (NCT03047577).
We used Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess history of alcohol use.
Emergency admitted adult ICU patients in three Finnish university hospitals, with an AUDIT-C score > 5 (women), or > 6 (men). We randomized consenting eligible patients to receive a BI or treatment as usual (TAU).
BI was delivered by the time of ICU discharge or shortly thereafter in the hospital ward.
Control patients received TAU.
The primary outcome was self-reported alcohol consumption during the preceding week 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality. The trial was terminated early due to slow recruitment during the pandemic.
We randomized 234 patients to receive BI (N = 117) or TAU (N = 117). At 6 months, the median alcohol intake in the BI and TAU groups were 6.5 g (interquartile range [IQR] 0-141) and 0 g (0-72), respectively (p = 0.544). At 12 months, it was 24 g (0-146) and 0 g (0-96) in the BI and TAU groups, respectively (p = 0.157). Median change in AUDIT-C from baseline to 6 months was - 1 (- 4 to 0) and 2 (- 6 to 0), (p = 0.144) in the BI and TAU groups, and to 12 months - 3 (- 5 to - 1) and - 4 (- 7 to - 1), respectively (p = 0.187). In total, 4% (n = 5) of patients in the BI group and 11% (n = 13) of patients in the TAU group were abstinent at 6 months, and 10% (n = 12) and 15% (n = 17), respectively, at 12 months. No between-groups difference in mortality emerged.
As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption.
ClinicalTrials.gov (NCT03047577).
摘要：
背景：建议筛查有害酒精使用并进行简短干预（BI），以减少与酒精相关的负面健康后果。我们旨在比较BI与常规护理在减少有危险酒精使用史的重症监护病房幸存者酒精摄入量方面的有效性（定义为至少10％的绝对差异）。
方法：我们使用酒精使用障碍鉴定测试-消费（AUDIT-C）评分来评估酒精使用史。
方法：在三家芬兰大学医院急诊收治的成年ICU患者，AUDIT-C评分>5（女性），或>6（男人）。我们随机同意符合条件的患者接受BI或照常治疗（TAU）。
方法：BI在ICU出院时或之后不久在医院病房分娩。
方法：对照组患者接受TAU。
结果：主要结果是在随机化后的前6周和12个月内自我报告的饮酒情况。次要结果是AUDIT-C评分从基线到6个月和12个月的变化，与健康相关的生活质量，和死亡率。由于大流行期间招募缓慢，该试验提前终止。
结果：我们随机分配234例患者接受BI（N=117）或TAU（N=117）。6个月时,BI组和TAU组的酒精摄入量中位数分别为6.5g（四分位距[IQR]0-141）和0g（0-72），分别(p=0.544)。12个月时,BI和TAU组为24g(0-146)和0g(0-96)，分别(p=0.157)。AUDIT-C从基线到6个月的中位数变化为-1（-4到0）和2（-6到0），（p=0.144）在BI和TAU组中，至12个月-3(-5至-1)和-4(-7至-1)，分别(p=0.187)。总的来说,BI组中4%(n=5)的患者和TAU组中11%(n=13)的患者在6个月时戒断,10%(n=12)和15%(n=17)，分别,在12个月。组间死亡率没有差异。
结论：由于动力不足，我们的研究无法拒绝或证实以下假设:与TAU相比,危重疾病后早期的单一BI可有效减少饮酒量.然而,两组中相当数量的人都减少了饮酒量。
背景：ClinicalTrials.gov（NCT03047577）。
方法：我们使用酒精使用障碍鉴定测试-消费（AUDIT-C）评分来评估酒精使用史。
方法：在三家芬兰大学医院急诊收治的成年ICU患者，AUDIT-C评分>5（女性），或>6（男人）。我们随机同意符合条件的患者接受BI或照常治疗（TAU）。
方法：BI在ICU出院时或之后不久在医院病房分娩。
方法：对照组患者接受TAU。
结果：主要结果是在随机化后的前6周和12个月内自我报告的饮酒情况。次要结果是AUDIT-C评分从基线到6个月和12个月的变化，与健康相关的生活质量，和死亡率。由于大流行期间招募缓慢，该试验提前终止。
结果：我们随机分配234例患者接受BI（N=117）或TAU（N=117）。6个月时,BI组和TAU组的酒精摄入量中位数分别为6.5g（四分位距[IQR]0-141）和0g（0-72），分别(p=0.544)。12个月时,BI和TAU组为24g(0-146)和0g(0-96)，分别(p=0.157)。AUDIT-C从基线到6个月的中位数变化为-1（-4到0）和2（-6到0），（p=0.144）在BI和TAU组中，至12个月-3(-5至-1)和-4(-7至-1)，分别(p=0.187)。总的来说,BI组中4%(n=5)的患者和TAU组中11%(n=13)的患者在6个月时戒断,10%(n=12)和15%(n=17)，分别,在12个月。组间死亡率没有差异。
结论：由于动力不足，我们的研究无法拒绝或证实以下假设:与TAU相比,危重疾病后早期的单一BI可有效减少饮酒量.然而,两组中相当数量的人都减少了饮酒量。
背景：ClinicalTrials.gov（NCT03047577）。
