Abstract
We investigated the relationship between alcohol and confusion in the ICU. We studied 83 patients, ranging in age from 65 to 81 years old, who were observed in the ICU after undergoing abdominal surgery. The patients were divided into two groups; patients who drank 25 g/day or more of alcohol (Group A), and non-drinkers (Group B). All patients were given a neuropsychological screening evaluation, including a mini-mental state test, the Japanese version of the state-trait anxiety inventory, a depression scale test and plasma cortisol concentration was measured before surgery, at 15 and 60 minutes after skin incision, the end of surgery, and 24 and 48 hr after surgery. Confusion in the ICU occurred in 7 of 18 patients (39%) in Group A and 4 of 65 patients (6%) in Group B. The occurrence of confusion in the ICU in patients of Group A was significantly higher than that in patients of Group B. Plasma cortisol concentrations 15 and 60 min after the skin incision, 60 min after the end of surgery, the next day and the 3rd day after surgery in patients of Group A (31.4±6.8, 29.2±7.6, 33.1±8.7, 29.4±6.9 and 28.3±5.8μg/dl) were significantly higher than those in patients of Group B (23.7±6.1, 21.4±7.4, 24.6±7.2, 19.5±6.4 and 18.7±6.0μg/dl). In conclusion, the incidence of confusion in the ICU was significantly higher in chronic alcohol drinkers than in no drinkers, and the plasma cortisol concentration was increased in chronic alcohol drinkers who developed confusion in ICU. Increased cortisol concentrations appear to be associated, or even to cause, confusion in the ICU in chronic alcohol drinkers.
