Screening for Alcohol Use Disorder Among Hospitalised Patients: Learning from a Retrospective Cohort Study in...

Area of Science:

• Public Health
• Clinical Medicine
• Epidemiology

Background:

• Excessive alcohol consumption is a leading cause of hospitalization and contributes to over 200 medical conditions in high-income countries.
• Understanding the prevalence and characteristics of alcohol use disorder (AUD) in secondary care is crucial for effective intervention.
• The distribution of AUD within ICD-10 discharge diagnosis groups and its relationship with other conditions requires investigation.

Purpose of the Study:

• To determine the prevalence and characteristics of alcohol use disorder (AUD) in hospitalized patients.
• To describe the distribution of AUD across ICD-10 discharge diagnosis groups.
• To ascertain the relationship between AUD and associated risk factors and diagnoses in secondary care.

Main Methods:

• Retrospective cohort study of adult patients admitted to Nottingham University Hospital (NUH) from April 2009 to March 2020.
• Uni- and multivariable logistic regression analyses were performed to identify risk factors and associations.
• AUD was identified using the AUDIT-C questionnaire, and diagnoses were categorized by ICD-10 codes.

Main Results:

• 16.5% of 44,804 admitted patients had AUD; 2.1% were alcohol-dependent.
• Patients aged 60-69, males, and those with emergency admissions showed higher odds of AUD.
• Individuals from minority ethnic backgrounds, females, and those from less deprived areas had lower odds of AUD. 64.7% of AUD patients had co-occurring mental and behavioral disorders.

Conclusions:

• One in six hospitalized patients presents with AUD, with specific demographic and admission-related risk factors.
• Mental and behavioral disorders are highly prevalent among hospitalized patients with AUD.
• The effectiveness of the AUDIT-C screening tool may vary in secondary care settings, necessitating careful consideration of ICD-10 diagnoses.