Respiratory Institute, Cleveland Clinic, Cleveland, OH, United States.
Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States; Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.
Alcohol. 2021 Jun;93:11-16. doi: 10.1016/j.alcohol.2021.03.002. Epub 2021 Mar 10.
Alcohol use disorder (AUD) is associated with significant direct morbidity and mortality. The impact of alcohol on chronic asthma and obstructive lung disease is unknown. AUD treatment may represent a potential target to improve healthcare utilization and healthcare costs in this patient population. Utilizing data from the 2012-2015 Nationwide Readmissions Database (NRD) and Nationwide Emergency Department Sample (NEDS), patients with a primary admission diagnosis of asthma or COPD were identified. Documented substance misuse, rates of hospitalization, frequency of hospital readmission, markers of admission severity, and cost were assessed. Within the NEDS cohort, 2,048,380 patients with a diagnosis of COPD or asthma were identified. Patients with documented AUD were more likely to present with respiratory failure [OR 1.32 (1.26, 1.39); p < 0.001] and more likely to require mechanical ventilation in the emergency room [OR 1.30 (1.19, 1.42); p < 0.001]. Within the NRD cohort, 1,096,663 hospital admissions were identified, of which 4.1% had documented AUD. AUD was associated with an increased length of stay [percentage increase estimate: 5% (4,6); p < 0.001], increased hospitalization cost, and an increased likelihood of 30-day readmission in patients with a primary admission diagnosis of COPD or asthma [OR 1.24 (1.2, 1.28); p < 0.001]. AUD is associated with increased disease morbidity and healthcare utilization in patients admitted with asthma or COPD. This impact persists after adjusting for substance misuse and associated comorbidities. Identifying and treating AUD in this patient population may improve disease, patient, and health-system outcomes.
酒精使用障碍（AUD）与显著的直接发病率和死亡率有关。酒精对慢性哮喘和阻塞性肺疾病的影响尚不清楚。AUD 治疗可能代表改善该患者人群医疗保健利用率和医疗保健成本的潜在目标。利用 2012-2015 年全国再入院数据库（NRD）和全国急诊部样本（NEDS）的数据，确定了以哮喘或 COPD 为主要入院诊断的患者。评估了记录的药物滥用、住院率、住院再入院频率、入院严重程度标志物和成本。在 NEDS 队列中，确定了 2048380 例患有 COPD 或哮喘诊断的患者。有记录 AUD 的患者更有可能出现呼吸衰竭[比值比 1.32（1.26，1.39）；p<0.001]，更有可能在急诊室需要机械通气[比值比 1.30（1.19，1.42）；p<0.001]。在 NRD 队列中，确定了 1096663 例住院治疗，其中 4.1%有记录的 AUD。AUD 与住院时间延长[百分比增加估计：5%（4,6）；p<0.001]、住院费用增加以及 COPD 或哮喘主要入院诊断患者 30 天再入院的可能性增加相关[比值比 1.24（1.2，1.28）；p<0.001]。AUD 与因哮喘或 COPD 入院的患者的疾病发病率和医疗保健利用率增加有关。在调整了药物滥用和相关合并症后，这种影响仍然存在。在该患者人群中识别和治疗 AUD 可能会改善疾病、患者和卫生系统的结果。
