Department of Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Hosp Med. 2012 Oct;7(8):617-21. doi: 10.1002/jhm.1953. Epub 2012 Jul 12.
The objective was to identify risk factors for multiple admissions for alcohol withdrawal syndrome (AWS) in patients admitted to a general medicine service.
A retrospective study was performed examining records of patients admitted for AWS between January 1, 2006 and December 31, 2008 to an academic tertiary referral hospital. Patients with a single admission were compared to patients with multiple admissions with respect to demographic and clinical variables.
Three hundred and twenty-two patients accounted for 788 admissions. Of the 322 patients, 142 (44%) had multiple admissions. Compared to patients with a single admission, patients with multiple admissions were more likely to have a high school education or less (p=0.0071), a higher Charlson comorbidity index score (p=0.0010), a positive urine drug screen for non-alcohol drug (p=0.0002), psychiatric comorbidity (p=0.0303) and a higher CIWA-Ar maximum total score (p<0.0001).
In patients with AWS, we identified demographic and clinical variables associated with multiple admissions to a general medicine service. Our results indicate areas for a targeted multidisciplinary and multispecialty approach at initial intervention, which is especially important given the high rates of recidivism in this patient population.
确定因酒精戒断综合征(AWS)而在综合医学科住院的患者多次住院的风险因素。
对 2006 年 1 月 1 日至 2008 年 12 月 31 日期间在学术性三级转诊医院因 AWS 住院的患者的记录进行了回顾性研究。将多次住院的患者与单次住院的患者进行了比较,比较了人口统计学和临床变量。
322 例患者共 788 次住院。在 322 例患者中,142 例(44%)有多次住院。与单次住院的患者相比,多次住院的患者更有可能接受过高中或以下教育(p=0.0071),Charlson 合并症指数评分较高(p=0.0010),尿液药物筛查阳性(非酒精药物)(p=0.0002),存在精神合并症(p=0.0303)和 CIWA-Ar 最大总评分较高(p<0.0001)。
在 AWS 患者中,我们确定了与综合医学科多次住院相关的人口统计学和临床变量。我们的结果表明,在初始干预时,需要针对特定的多学科和多专业方法,这在该患者群体中复发率高的情况下尤为重要。