Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

doi:10.1080/08897077.2015.1137259

. 2016 Jul-Sep;37(3):466-473.

doi: 10.1080/08897077.2015.1137259. Epub 2016 Jan 5.

Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

Brendan J Clark¹, Anna D Rubinsky^{2

3}, P Michael Ho^{4

5}, David H Au³, Laura J Chavez³, Marc Moss¹, Katharine A Bradley^{2

3

6}

Affiliations

¹ a Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado , Aurora , Colorado , USA.
² b Center of Excellence for Substance Abuse Treatment and Education , Department of Veterans Affairs Puget Sound Health Care System , Seattle , Washington , USA.
³ c Health Services Research and Development , Department of Veterans Affairs Puget Sound Health Care System , Seattle , Washington , USA.
⁴ d Division of Cardiology, Department of Medicine, Denver VA Medical Center , Denver , Colorado , USA.
⁵ e Department of Medicine , Division of Cardiology, University of Colorado , Aurora , Colorado , USA.
⁶ f Group Health Research Institute , Seattle , Washington , USA.

PMID: 26730984
PMCID: PMC5669033
DOI: 10.1080/08897077.2015.1137259

Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

Brendan J Clark et al. Subst Abus. 2016 Jul-Sep.

. 2016 Jul-Sep;37(3):466-473.

doi: 10.1080/08897077.2015.1137259. Epub 2016 Jan 5.

Authors

Brendan J Clark¹, Anna D Rubinsky^{2

3}, P Michael Ho^{4

5}, David H Au³, Laura J Chavez³, Marc Moss¹, Katharine A Bradley^{2

3

6}

Affiliations

¹ a Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado , Aurora , Colorado , USA.
² b Center of Excellence for Substance Abuse Treatment and Education , Department of Veterans Affairs Puget Sound Health Care System , Seattle , Washington , USA.
³ c Health Services Research and Development , Department of Veterans Affairs Puget Sound Health Care System , Seattle , Washington , USA.
⁴ d Division of Cardiology, Department of Medicine, Denver VA Medical Center , Denver , Colorado , USA.
⁵ e Department of Medicine , Division of Cardiology, University of Colorado , Aurora , Colorado , USA.
⁶ f Group Health Research Institute , Seattle , Washington , USA.

PMID: 26730984
PMCID: PMC5669033
DOI: 10.1080/08897077.2015.1137259

Abstract

Background: The association between alcohol misuse and the need for intensive care unit admission as well as hospital readmission among those discharged from the hospital following a critical illness is unclear. This study sought to determine whether alcohol misuse was associated with (1) admission to an intensive care unit (ICU) among a cohort of patients receiving outpatient care and (2) hospital readmission among those discharged from the hospital following critical illness.

Methods: This was a retrospective cohort study conducted with data from 24 Veterans Affairs (VA) health care facilities between 2004 and 2007. Scores on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire were used to identify patients with past-year abstinence, lower-risk alcohol use, moderate alcohol misuse, or severe alcohol misuse. The primary outcome was admission to a VA intensive care unit within the year following administration of the AUDIT-C. In an analysis focused on patients discharged from the ICU, the 2 main outcomes were hospital readmission within 1 year and within 30 days.

Results: Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0% (95% confidence interval [CI]: 1.7%-2.3%) for abstinent patients, 1.6% (95% CI: 1.3%-1.8%) for patients with lower-risk alcohol use, 1.8% (1.4%-2.3%) for patients with moderate alcohol misuse, and 2.5% (2.0%-2.9%) for patients with severe alcohol misuse. Among the 9,030 patients discharged from an ICU, the adjusted probability of hospital readmission within 1 year was 48% (46%-49%) in abstinent patients, 44% (42%-45%) in patients with lower-risk alcohol use, 42% (39%-45%) in patients with moderate alcohol misuse, and 55% (49%-60%) in patients with severe alcohol misuse.

Conclusions: Alcohol misuse may represent a modifiable risk factor for a cycle of ICU admission and subsequent hospital readmission.

Keywords: Alcohol abuse; alcohol consumption; alcohol-related disorders; health care utilization; intensive care units; patient readmission.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

**Figure 1**
Patients included in the study sample.

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References

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[1] Friedmann PD. Clinical practice. Alcohol use in adults. N Engl J Med. 2013;368(4):365–373. - PubMed

[2] Friedmann PD. Clinical practice. Alcohol use in adults. N Engl J Med. 2013;368(4):365–373. - PubMed

[3] Schuckit MA. Alcohol-use disorders. Lancet. 2009;373(9662):492–501. - PubMed

[4] Schuckit MA. Alcohol-use disorders. Lancet. 2009;373(9662):492–501. - PubMed

[5] Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med. 2011;41(5):516–524. - PubMed

[6] Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med. 2011;41(5):516–524. - PubMed

[7] Harwood H. Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data. In: NIAAAa, editor. Alcoholism. Vol. 98. Rockville, MD: National Institutes of Health; 2000. p. 4327.

[8] Harwood H. Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data. In: NIAAAa, editor. Alcoholism. Vol. 98. Rockville, MD: National Institutes of Health; 2000. p. 4327.

[9] Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. - PubMed

[10] Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. - PubMed

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Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

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Alcohol screening scores and the risk of intensive care unit admission and hospital readmission

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