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Predictors of Alcohol Withdrawal Readmissions.
Siva Harsha Yedlapati1, Scott H Stewart1
1Division of General Internal Medicine, Erie County Medical Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 462 Grider Street, Buffalo, NY, USA.
Alcohol and Alcoholism (Oxford, Oxfordshire)
|April 5, 2018
Summary
Hospital readmissions for alcohol withdrawal (AW) are common, with high rates of 30-day and multiple yearly readmissions. Discharge against medical advice and comorbid psychotic disorder strongly predict these readmissions.
Area of Science:
- Medical Quality
- Public Health
- Addiction Medicine
Background:
- Hospital readmissions are key indicators of healthcare quality.
- Alcohol withdrawal (AW) can lead to frequent hospitalizations and readmissions.
- Understanding AW readmission patterns is crucial for improving patient outcomes and reducing healthcare costs.
Purpose of the Study:
- To evaluate the rates of alcohol withdrawal (AW)-related readmissions.
- To identify predictors of 30-day and multiple AW readmissions within a one-year period.
- To analyze a nationally representative sample to understand AW readmission trends.
Main Methods:
- Utilized data from the 2013 Nationwide Readmissions Database (NRD).
- Included patients with alcohol withdrawal (AW) as a primary or secondary diagnosis.
- Performed cross-sectional and retrospective analyses using regression methods suitable for complex survey data.
Main Results:
- In 2013, 393,118 discharges involved AW coding; 41.5% listed AW as the primary diagnosis.
- The estimated AW-related readmission rate was 58.8%, with an average of 1.8 readmissions per patient.
- The 30-day readmission rate was 19.7%; discharge against medical advice (AMA) and comorbid psychotic disorder were the strongest predictors.
Conclusions:
- Alcohol withdrawal (AW) readmissions within 30 days and multiple yearly readmissions are prevalent.
- Discharge against medical advice (AMA) and comorbid psychotic disorder are significant predictors of AW readmissions.
- Identifying high-risk patients is essential, and further research into causal mechanisms can improve AW treatment outcomes and costs.
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