
This study investigated the association between substance misuse and mortality among ICU patients with pneumonia. The study used retrospective data from hospitals between 2010 and 2017 and identified substance misuse related to alcohol, cannabis, opioids, stimulants, or more than one substance using the International Classification of Diseases. Of the 167,095 ICU patients with pneumonia, 5.0% had alcohol misuse, 0.6% had cannabis misuse, 1.5% had opioid misuse, 0.6% had stimulant misuse, and 1.2% had misuse of more than one substance. In unadjusted analyses, alcohol misuse was associated with increased in-hospital mortality, while opioid misuse was associated with decreased mortality. These associations persisted in adjusted analyses. However, the relationships between cannabis, stimulant, and more than one substance misuse and mortality were not consistently present after adjustment. The study concludes that substance misuse subtypes are associated with different effects on mortality in ICU patients with pneumonia, and the biases inherent in administrative data should be considered when interpreting the results.
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