From the Medicine Service, Birmingham Veterans Affairs (VA) Medical Center; and Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
J Clin Rheumatol. 2022 Mar 1;28(2):e375-e380. doi: 10.1097/RHU.0000000000001731.
To examine the incidence, time trends, and outcomes of alcohol use disorder (AUD) hospitalizations in people with gout, rheumatoid arthritis (RA), fibromyalgia, osteoarthritis, or low back pain (LBP).
We used the US National Inpatient Sample data from 1998 to 2016. We examined the rates of AUD hospitalizations in musculoskeletal diseases (MSDs), based on the presence of diagnostic codes for AUD in the primary and MSDs in a secondary position. Multivariable-adjusted (age, sex, race, and income) health care utilization and in-hospital mortality were compared by the presence/absence of MSDs, using linear or logistic regression.
Alcohol use disorder hospitalizations increased over the 19-year study period from 1998 to 2014 to 3-fold higher in gout, osteoarthritis, or LBP; 3.5-fold in RA; and 4.5-fold in fibromyalgia. Compared with AUD hospitalizations in people without each respective MSD, adjusted total hospital charges were $3913 higher in people with gout and $1368 to $1614 lower for osteoarthritis, fibromyalgia, or LBP over the study period (all significant) and not significantly different for RA. The adjusted odds of hospital stay of more than 3 days were significantly higher for all 5 MSDs, with odds ratio ranging 1.10 for LBP to 1.34 for gout. The adjusted odds of in-hospital mortality were significantly lower for all 5 MSDs, with odds ratio ranging from 0.21 for fibromyalgia to 0.50 for gout.
In a national US study, the rate of AUD hospitalizations increased in all 5 MSDs. Providers and patients with MSDs should be counseled regarding the risk and impact of alcohol use. Interventions to reduce AUD hospitalization-associated health care burden in MSD are needed.
研究痛风、类风湿关节炎（RA）、纤维肌痛、骨关节炎或腰痛（LBP）患者中酒精使用障碍（AUD）住院的发生率、时间趋势和结局。
我们使用了 1998 年至 2016 年美国国家住院患者样本数据。我们根据 AUD 的诊断代码在主要位置和 MSD 中的次要位置存在的情况，检查了 MSD 中 AUD 住院率。使用线性或逻辑回归比较了 MSD 存在/不存在时多变量调整（年龄、性别、种族和收入）的医疗保健利用情况和院内死亡率。
在 19 年的研究期间，从 1998 年到 2014 年，痛风、骨关节炎或 LBP 中 AUD 住院率增加了 3 倍；RA 增加了 3.5 倍；纤维肌痛增加了 4.5 倍。与每种特定 MSD 患者的 AUD 住院率相比，痛风患者的调整后总住院费用高出 3913 美元，而在研究期间，骨关节炎、纤维肌痛或 LBP 的调整后费用则低 1368 至 1614 美元（均具有统计学意义），而 RA 则无统计学差异。所有 5 种 MSD 的住院时间超过 3 天的调整后比值比均显著升高，比值比范围为 LBP 的 1.10 至痛风的 1.34。所有 5 种 MSD 的调整后院内死亡率均显著降低，比值比范围为纤维肌痛的 0.21 至痛风的 0.50。
在一项美国全国性研究中，所有 5 种 MSD 的 AUD 住院率均有所增加。MSD 患者和提供者应接受有关饮酒风险和影响的咨询。需要采取干预措施来降低 MSD 中 AUD 住院相关的医疗保健负担。
