The Effect of Alcohol Policy on Intensive Care Unit Admission Patterns in Central Australia: A Before–After Cross-Sectional Study
Abstract
Introduction
At-risk alcohol use 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.
Method
A retrospective before–after cross-sectional study was conducted at the Alice Springs Hospital ICU between October 1, 2017 and September 30, 2019. The primary outcome was the proportion of admissions in which at-risk alcohol use 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).
Results
After exclusions, 1323 ICU admissions were analysed. There was a reduction in the proportion of admissions associated with at-risk alcohol use 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 cases (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).
Conclusion
This study demonstrated a reduction in ICU admissions associated with at-risk alcohol use following the implementation of new alcohol harm minimization policies. This apparent reduction in alcohol-related harm is suggestive of the effectiveness of the Northern Territory’s integrated alcohol harm reduction framework.
