Karolinska Institutet, Social medicine, Department of Public Health Sciences, Karolinska Institutet, Box 170 70, SE - 104 62 Stockholm, Sweden.
BMC Public Health. 2011 Jul 19;11:574. doi: 10.1186/1471-2458-11-574.
Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care.
All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735). Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication.
Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care.
While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.
在瑞典,因酒精中毒住院治疗的人数不断增加,尤其是年轻女性。众所周知,酒精紊乱是一种慢性复发性疾病,因此本研究旨在评估患者再次接受治疗的程度。
通过登记册,对 1997 年斯德哥尔摩县所有与酒精相关的诊断住院患者进行前瞻性随访,直至 2007 年。计算每位患者在基线后每年因同一诊断、其他与酒精相关的住院或门诊治疗而再次出现的比例(n=2735),并计算再次出现的年数。分别检查了三种诊断,即酒精依赖、有害饮酒和酒精中毒。
在接下来的十年中,五分之三的酒精诊断住院患者再次出现酒精相关的住院治疗。再次出现的比例在基线后的第一年最大,然后随着时间的推移呈曲线下降。包括门诊治疗后,增加了比例,但没有改变模式。在基线时患有酒精依赖诊断的患者中,42%的人在第一年、28%的人在第五年和 25%的人在第十年再次出现酒精相关的住院治疗。有害饮酒和中毒的相应比例较小。在那些患有酒精依赖的患者中,每五人中有一人在十年中接受了超过五次的治疗。有序逻辑回归证实,除了诊断外,年龄和性别与再次接受治疗的年数独立相关。
尽管中年男性酒精依赖患者处于循环状态,但年轻女性因中毒诊断而再次入院的程度则相对较低。