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Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder
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Chronic Intermittent Ethanol Vapor Exposure Paired with Two-Bottle Choice to Model Alcohol Use Disorder

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Risk factors associated with 1-week revisit among emergency department patients with alcohol withdrawal

Frank X Scheuermeyer1,2,3, Daniel Lane4, Brian Grunau5,6

  • 1Department of Emergency Medicine, St Paul's Hospital and The University of British Columbia, Vancouver, BC, Canada. frank.scheuermeyer@gmail.com.

CJEM
|January 16, 2023
PubMed

Insights

Approximately 15% of patients treated for alcohol withdrawal in the emergency department (ED) return within a week. Factors like prior ED visits, homelessness, high blood alcohol levels, and severe withdrawal symptoms increase this risk.

Area of Science:

  • Emergency Medicine
  • Addiction Psychiatry
  • Public Health

Background:

  • Alcohol withdrawal is a common reason for emergency department (ED) visits.
  • A significant proportion of patients discharged after alcohol withdrawal treatment experience unscheduled return visits within one week.
  • Predictors for these revisits remain incompletely understood.

Purpose of the Study:

  • To identify patient and clinical factors associated with a high risk of 1-week ED revisits after discharge for alcohol withdrawal.
  • To inform discharge planning and follow-up strategies for at-risk individuals.

Main Methods:

  • Retrospective chart review of 935 ED visits for alcohol withdrawal across three urban EDs in Vancouver, Canada (2015-2018).
  • Inclusion criteria: patients discharged with a primary or secondary diagnosis of alcohol withdrawal.
  • Statistical analysis: Univariable and multivariable Bayesian binomial regression to identify factors associated with being in the upper quartile of 1-week ED revisits.

Main Results:

  • The overall 1-week ED revisit rate was 15.0%.
  • Factors independently associated with a high risk of revisit included: prior ED visit within 30 days, homelessness (no fixed address), initial blood alcohol level > 45 mmol/L, and initial Clinical Institute Withdrawal Assessment-alcohol revised (CIWA-Ar) score > 23.
  • These identified factors explained 41% of the variance in revisit rates.

Conclusions:

  • Specific patient and clinical factors are associated with increased 1-week ED revisits for alcohol withdrawal.
  • Identifying high-risk patients can aid clinicians in developing targeted discharge plans and integrated follow-up support.
  • Further research may explore interventions to reduce alcohol withdrawal-related ED revisits.
Abstract

Keywords:
Alcohol use disorderAlcohol withdrawal

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