Is the Presence of an Alcohol-Attributable Admitting Diagnosis Associated with Decreased Drinking after Hospitalization?
To assess whether physical health status is associated with drinking after hospitalization, researchers conducted a secondary analysis of data from a randomized trial of hospital-based BI in 341 medical inpatients with unhealthy alcohol use. Separate adjusted models were used to test the association between 5 physical health measures (recent medical comorbidities, lifetime medical comorbidities, physical health status, any alcohol-attributable medical diagnosis, and alcohol-attributable principal admitting diagnosis) and number of heavy drinking days (HDDs*) in the 30 days prior to the 3-month post-hospitalization assessment.
- Overall, there was no association between the 5 measures of physical health and HDDs.
- In analyses testing for interactions, an alcohol-attributable principal admitting diagnosis was associated with significantly fewer HDDs among participants with low perception of an alcohol problem at hospital admission (adjusted incidence rate ratio [aIRR], 0.36) or with nondependent drinking (aIRR, 0.10).
- An alcohol-attributable principal admitting diagnosis was present in 4 nondependent drinkers and 9 individuals with low perception of an alcohol problem.
Comments:
These interesting results suggest that an alcohol-attributable principal admitting diagnosis may serve as a “wake-up call” to medical inpatients with low perception of an alcohol problem or nondependent drinking. The results imply that hospital-based interventions may be more successful if they focused on the link between alcohol-attributable diagnoses and alcohol use in appropriate patients. However, it is important to note that, depending on a hospital’s proportion of dependent to nondependent inpatients and alcohol-attributable admitting diagnoses, this may apply to only a small minority of hospitalized patients with unhealthy alcohol use.
Kevin L. Kraemer, MD, MSc
Reference:
Williams EC, Palfai T, Cheng DM, et al. Physical health and drinking among medical inpatients with unhealthy alcohol use: a prospective study. Alcohol Clin Exp Res. 2010;34(7):1–9.