Lehigh Valley Health Network, USF Morsani College of Medicine, Allentown, PA, United States of America.
Lehigh Valley Health Network, USF Morsani College of Medicine, Allentown, PA, United States of America.
Am J Emerg Med. 2021 Dec;50:156-159. doi: 10.1016/j.ajem.2021.07.058. Epub 2021 Jul 31.
Alcohol withdrawal syndrome (AWS) is a serious consequence of alcohol use disorder (AUD). Due to the current COVID-19 pandemic there was a closure of Pennsylvania (PA) liquor stores on March 17, 2020.
This is a retrospective, observational study of AWS patients presenting to a tertiary care hospital. We used descriptive statistics for continuous and categorical variables and compared AWS consults placed to the medical toxicology service for six months preceding liquor store closure to those placed between March 17, 2020 and August 31, 2020. We compared this to consults placed to the medical toxicology service placed from October 1, 2019 through March 16, 2020. Charts were identified based on consults placed to the medical toxicology service, and alcohol withdrawal was determined via chart review by a medical toxicologist. This study did not require IRB approval. We evaluated Emergency Department (ED) length of stay (LOS), weekly and monthly consultation rate, rate of admission and ED recidivism, both pre- and post-liquor store closure.
A total of 324 AWS consults were placed during the ten month period. 142 (43.8%) and 182 (56.2%) consults were pre- and post-liquor store closure. The number of consults was not statistically significant comparing these two time frames. There was no significant difference by patient age, gender, or race or by weekly or monthly consultation rate when comparing pre- and post-liquor store periods. The median ED LOS was 7 h (95% Confidence Interval (CI) Larson et al. (2012), Pollard et al. (2020) [5, 11]) and did not significantly differ between pre- and post-liquor store periods (p = 0.78). 92.9% of AWS patients required admission without significant difference between the pre- and post-liquor store closure periods (94.4% vs. 91.8%, p = 0.36). There was a significant increase in the number of AWS patients requiring a return ED visit (Odds Ratio 2.49; 95% CI [1.38, 4.49]) post closure.
There were nearly 2.5 times greater odds of ED recidivism among post-liquor store closure AWS patients compared with pre-closure AWS patients.
酒精戒断综合征（AWS）是酒精使用障碍（AUD）的严重后果。由于当前 COVID-19 大流行，宾夕法尼亚州（PA）的酒类商店于 2020 年 3 月 17 日关闭。
这是一项对三级保健医院就诊的 AWS 患者的回顾性观察性研究。我们使用连续和分类变量的描述性统计数据，并将酒类商店关闭前六个月向医疗毒理学服务部门转介的 AWS 咨询与 2020 年 3 月 17 日至 2020 年 8 月 31 日之间转介的 AWS 咨询进行比较。我们将其与 2019 年 10 月 1 日至 2020 年 3 月 16 日期间向医疗毒理学服务部门转介的咨询进行比较。根据向医疗毒理学服务部门转介的咨询来确定图表，并且通过医疗毒理学家对图表进行审查来确定酒精戒断。这项研究不需要 IRB 批准。我们评估了急诊部（ED）的住院时间（LOS）、每周和每月的咨询率、住院率和 ED 再入院率，包括酒类商店关闭前后。
在十个月的时间里，共进行了 324 次 AWS 咨询。在酒类商店关闭前后，分别有 142 次（43.8%）和 182 次（56.2%）咨询。这两个时间段的咨询次数没有统计学意义。比较酒类商店关闭前后，患者的年龄、性别、种族或每周和每月的咨询率没有显著差异。ED LOS 的中位数为 7 小时（95%置信区间（CI）Larson 等人，2012 年；Pollard 等人，2020 年）[5,11]，并且在酒类商店关闭前后没有显著差异（p=0.78）。AWS 患者中有 92.9%需要住院治疗，酒类商店关闭前后无显著差异（94.4%比 91.8%，p=0.36）。酒类商店关闭后，需要返回 ED 就诊的 AWS 患者数量显著增加（优势比 2.49；95%置信区间[1.38,4.49]）。
与酒类商店关闭前的 AWS 患者相比，酒类商店关闭后 AWS 患者 ED 再入院的可能性增加了近 2.5 倍。
