| Summary: | Abstract Alcohol consumption is a major health problem worldwide, causing approximately 5% of all deaths per year. High-risk alcohol consumption causes acute and chronic disorders that are often treated in intensive care units (ICUs). The magnitude of alcohol-related health problems amongst critically ill patients has not yet been well studied. The aim of this thesis was to examine the role of high-risk alcohol consumption in critical illness. It includes four retrospective studies conducted in the Oulu University Hospital district. The study populations comprised the following: I) 899 non-trauma patients admitted to the ICU in 2014; II) 8379 subjects born in 1966 participating in the Northern Finland Birth Cohort study; III) 250 patients with liver cirrhosis or other liver disease admitted to the ICU in 2017; and IV) 290 sudden cardiac death (SCD) victims with alcoholic cardiomyopathy (ACM). One-third of the ICU-admitted patients had alcohol-related health problems. Alcohol consumption did not affect the ICU treatment profile, but one-year mortality was lower in patients with alcohol-related health problems due to less severe admission causes and comorbidities. This difference subsided when patients with intoxication as the ICU admission cause were excluded. Alcohol consumption ≥ 11 g/day at the age of 31 years was associated with a later need for ICU admission. The ICU-admitted patients with high alcohol consumption more often had alcohol-related admission causes (25.0%) compared with those without high alcohol consumption. Nearly 40% of the ICU-admitted patients with liver disease died during the one-year follow-up period. Alcohol consumption did not affect long-term mortality, but the patients with alcoholic liver cirrhosis died more often due to liver disease (56.8%), whereas the patients without high-risk alcohol consumption died more often due to malignancies (55.9%). Amongst the SCD victims with ACM, only 22.1% of the victims were diagnosed with cardiac disease prior to death, despite documented ...
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