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• When problems with drinking become severe.
• Drinking alcohol may be identified by means of validated tools such as the Alcohol Use Disorders Identification Test (AUDIT).

• Epidemiologic data from 2014 indicate that 16.3 million adults suffer from AUDs in the US. 

Risk factor for the development of Pneumonia 

• When pneumonia occurs in AUD patients, it is often complicated by extra-pulmonary disease such as the development of bacteremia, sepsis, and septic shock, with attendant poor outcomes.
• Pneumonia is the most common cause of death from infectious disease in the US that imposes an economic burden of more than $17 billion annually.
• Patients with AUDs having pneumonia or sepsis are at a two-fold increased risk of developing the acute respiratory distress syndrome (ARDS), characterized by the acute onset of non-cardiogenic pulmonary edema and respiratory failure requiring mechanical ventilation. 

Risk factor for the development of Acute Respiratory Distress Syndrome (ARDS)

• ARDS carries a mortality risk of 29-42%, and is responsible for 75,000 deaths annually in the US.
• Patients with AUD-associated ARDS fare still more poorly, requiring prolonged hospitalizations and having a mortality of 59-65%.