Gili-Miner Miguel, Béjar-Prado Luis, Gili-Ortiz Enrique, Ramírez-Ramírez Gloria, López-Méndez Julio, López-Millán José-Manuel, Sharp Brett
Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain.
Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain.
Drug Alcohol Depend. 2014 Apr 1;137:55-61. doi: 10.1016/j.drugalcdep.2014.01.009. Epub 2014 Jan 30.
Alcohol use disorders (AUD) have been associated with an increased risk of unplanned hospital readmissions (URA). We analyzed in a sample of 87 Spanish Hospitals if surgical patients with AUD had a higher risk of URA and if among patients with URA, those with AUD had an excess length of hospital stay, higher hospital expenses and increased risk of mortality.
We analyzed data of patients who underwent surgical operations during the period between 2008 and 2010. URA was defined as unplanned readmissions during the first 30 days after hospital departure. The primary outcome was risk of URA in patients with AUD. Secondary outcomes were mortality, excess length of stay and over expenditure.
A total of 2,076,958 patients who underwent surgical operations were identified: 68,135 (3.3%) had AUD, and 62,045 (3.0%) had at least one URA. Among patients with AUD 4212 (6.2%) had at least one URA and among patients without AUD 57,833 (2.9%) had at least one URA. Multivariable analysis demonstrated that AUD was an independent predictor of developing URA (Odds ratio: 1.56; 95% CI: 1.50-1.62). Among surgical patients with URA, those with AUD had longer lengths of hospital stay (2.9 days longer), higher hospital costs (2885.8 Euros or 3858.3 US Dollars), higher risk of death (OR: 2.16, 95% CI: 1.92-2.44) and higher attributable mortality (11.2%).
Among surgical patients, AUD increase the risk of URA, and among patients with URA, AUD heighten the risk of in-hospital death, and cause longer hospital stays and over expenditures.
酒精使用障碍（AUD）与非计划住院再入院（URA）风险增加有关。我们在87家西班牙医院的样本中分析了患有AUD的外科手术患者是否有更高的URA风险，以及在URA患者中，患有AUD的患者是否住院时间更长、住院费用更高且死亡风险增加。
我们分析了2008年至2010年期间接受外科手术的患者数据。URA定义为出院后前30天内的非计划再入院。主要结局是患有AUD的患者发生URA的风险。次要结局是死亡率、住院时间延长和费用超支。
共识别出2076958例接受外科手术的患者：68135例（3.3%）患有AUD，62045例（3.0%）至少有一次URA。在患有AUD的患者中，4212例（6.2%）至少有一次URA，在无AUD的患者中，57833例（2.9%）至少有一次URA。多变量分析表明，AUD是发生URA的独立预测因素（比值比：1.56；95%置信区间：1.50 - 1.62）。在患有URA的外科手术患者中，患有AUD的患者住院时间更长（长2.9天）、住院费用更高（2885.8欧元或3858.3美元）、死亡风险更高（比值比：2.16，95%置信区间：1.92 - 2.44）以及可归因死亡率更高（11.2%）。
在外科手术患者中，AUD增加URA风险，在URA患者中，AUD增加住院死亡风险，并导致住院时间延长和费用超支。
