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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Dylan W. de Lange, University Medical Center Utrecht
- Second opponent: Professor Anne Berit Guttormsen, Haukeland University Hospital
- Third member and chair of the evaluation committee: Professor Dan Atar, University of Oslo
Chair of the Defence
Professor Emeritus Sverre Erik Kjeldsen, Faculty of Medicine, University of Oslo
Principal Supervisor
Professor II Dag Jacobsen, Faculty of Medicine, University of Oslo
Summary
Alcohol and drug abuse is associated with a variety of medical conditions in intensive care (ICU) patients. However, although substance abuse represents a potentially modifiable risk factor for critical illness, the scope of alcohol and drug-related disease within the Norwegian ICU population has not been extensively studied.
The aim of the thesis was to study the preadmission and clinical characteristics of a mixed medical and surgical ICU population in Oslo, with particular emphasis on the impact of substance abuse of alcohol and drugs. Designed as an observational cohort study, the study population comprised 861 patients admitted to the ICUs at the Oslo University Hospital Ullevaal and the Diakonhjemmet Hospital during a one-year period from 2014 to 2015. Data was collected consecutively, based on information from a questionnaire, including the alcohol screening test AUDIT-C, medical records, and toxicology results. Trauma, cardiovascular disease, and sepsis were the most common diagnostic categories.
Overall, 30% of the patients had either alcohol or drug-related cause of ICU admission and/or underlying chronic substance abuse. Of these, 19% were mainly alcohol-related and 11% drug-related. The results indicate that substance abuse of alcohol and drugs is both a common predisposing factor for ICU admission and an important comorbidity factor among Norwegian ICU patients both with and without substance abuse-related causes of ICU admission. Routine screening for alcohol and drug abuse in ICU patients may contribute to a more systematic identification of ICU patients with substance abuse, which consequently could improve outcome for these patients. The high response rate of the questionnaire used in the present study indicates that this is feasible. Furthermore, the high proportion of ICU patients with substance abuse-related conditions may be of interest to the Norwegian health authorities by demonstrating a need for enhanced prevention efforts.
Additional information
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