Accesses for alcohol intoxication to the emergency department and the risk of re-hospitalization: An observational retrospective study. (February 2018)

• Record Type: Journal Article
• Authors: Baldassarre, Maurizio; Caputo, Fabio; Pavarin, Raimondo Maria; Bossi, Matteo Massimo; Bonavita, Maria Elena; Caraceni, Paolo; Grignaschi, Alice; Balloni, Mimosa; Cavazza, Mario; Bernardi, Mauro; Domenicali, Marco
• Is Part Of: Addictive behaviors. Volume 77(2018)
• Page Start: 1
• Page End: 6
• Publication Date: 2018-02
• Subjects: AAI acute alcohol intoxication -- AUD alcohol use disorders -- BAC blood alcohol concentration -- ED emergency department; Alcohol use disorder -- Emergency department -- Re-hospitalization; Substance abuse -- Periodicals; Alcoholism -- Periodicals; Drug addiction -- Periodicals; Nicotine addiction -- Periodicals; Smoking -- Periodicals; Gambling -- Psychological aspects -- Periodicals; Electronic journals; 362.29
• DOI: 10.1016/j.addbeh.2017.08.031
• Languages: English
• ISSNs: 0306-4603

Abstract

Abstract: Background: Alcohol use disorders (AUD) are a frequent cause of admission to emergency departments (EDs) for acute alcohol intoxication (AAI). Patients with AUD present a higher risk of readmission to EDs for AAI than the general population, however, the distinction between sporadic AAI and AAI in the context of AUD in the ED setting is difficult. Aims: To analyze the epidemiological characteristics of patients admitted to EDs because of AAI and to identify factors associated with repeated admissions in order to develop a risk stratification system for patients with AUD based on objective data that can be easily applied in an ED setting. Methods: An observational retrospective study was performed. All patients with diagnosis of AAI at admission in 2014 were enrolled. Results: Five hundred and sixty-five patients were enrolled, of which 92 (16%) were admitted more than once to the ED. At multivariate analysis, factors associated with readmission were past episodes of alcohol abuse, social discomfort, previous traumas and psychiatric disorders. Basing on this parameter, a risk-score for re-hospitalization was developed. This score has a high predictive power for the risk of readmission to the ED (AROC 0.837, 95%CI 0.808–0.866), moreover, the cumulative probability of readmission within one year, increased in parallel with score value, being highest in patients presenting 3 or more risk factors. Conclusion: The present study demonstrates that several risk factors stratify the risk of re-hospitalization in patients admitted to EDs for AAI, allowing the identification of those presenting more severe conditions and who would likely benefit from multidisciplinary intervention. Highlights: Patients with multiple admissions to the EDs for AAI need an accurate evaluation for AUD. Several risk factors stratify the risk of re-hospitalization in patients admitted to EDs for AAI. Clinical informations available in ED allows the identification of those patients needing a second level evaluation.