Koopmann Anne, Hoffmann Sabine, Riegler Alisa, Cordes Jaspar, Kiefer Falk
Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für Seelische Gesundheit Mannheim, J5, 68159, Mannheim, Deutschland.
Feuerlein Center für Translationale Suchtmedizin (FCTS, ), Ruprecht-Karls Universität Heidelberg, Heidelberg, Deutschland.
Nervenarzt. 2025 May;96(3):278-283. doi: 10.1007/s00115-024-01738-x. Epub 2024 Sep 16.
According to data from the Federal Statistical Office, the diagnosis of alcohol use disorder (AUD) (F 10) is the second most common main diagnosis for hospital treatment. Those affected by this disorder are often repeatedly hospitalized at short intervals due to relapses; however, little is known about the factors that influence readmission rates after initial treatment.
The aim of this retrospective analysis is to analyze the effects of treatment type (qualified withdrawal treatment (QE) versus physical detoxification) and discharge mode on the probability of readmission in alcohol-dependent patients after inpatient treatment.
Data from 981 male and female alcohol-dependent patients who completed either qualified withdrawal treatment (QE) (68% men; mean age 47.6 years) or inpatient detoxification (74% men; mean age 48.0 years) were analyzed. Predictors of regular discharge were determined separately for both types of treatment using stepwise logistic regression.
Patients who had completed a qualified withdrawal treatment were significantly more likely to be regularly discharged. Regular completion of the qualified withdrawal treatment (QE) led to a relative reduction in the readmission rate of 25.64% within 1 year compared to a physical detoxification.
In order to prevent readmission and chronic courses of alcohol use disorder (AUD), qualified withdrawal treatment should always be recommended to affected patients instead of physical detoxification. Aktuelle Daten des Statistischen Bundesamtes für das Jahr 2022 zeigen, dass die Diagnose "Psychische und Verhaltensstörungen durch Alkohol (F 10.X)" die zweithäufigste Hauptdiagnose bei Krankenhausbehandlungen darstellt [13]. Im Gesundheitssystem entstehen durch dieses Erkrankungsbild und seine somatischen und psychischen Folgeerkrankungen jährlich ca. 10 Mrd. € direkte Kosten [13]. Dieser Sachverhalt wird dadurch kontrastiert, dass die Krankenkassen die qualifizierte Entzugsbehandlung (QE) als leitliniengerechte Goldstandardtherapie [4] wiederholt infrage stellen [10].
根据联邦统计局的数据，酒精使用障碍（AUD）（F10）的诊断是医院治疗中第二常见的主要诊断。受这种疾病影响的人往往由于复发而在短时间内反复住院；然而，对于影响初始治疗后再入院率的因素知之甚少。
这项回顾性分析的目的是分析治疗类型（合格戒断治疗（QE）与身体脱毒）和出院方式对酒精依赖患者住院治疗后再入院概率的影响。
分析了981名完成合格戒断治疗（QE）（68%为男性；平均年龄47.6岁）或住院脱毒（74%为男性；平均年龄48.0岁）的男性和女性酒精依赖患者的数据。使用逐步逻辑回归分别确定两种治疗类型的正常出院预测因素。
完成合格戒断治疗的患者更有可能正常出院。与身体脱毒相比，合格戒断治疗（QE）的正常完成导致1年内再入院率相对降低25.64%。
为了预防酒精使用障碍（AUD）的再入院和慢性病程，应始终向受影响的患者推荐合格戒断治疗，而不是身体脱毒。联邦统计局2022年的最新数据显示，“酒精所致精神和行为障碍（F10.X）”的诊断是医院治疗中第二常见的主要诊断[13]。由于这种疾病及其躯体和精神并发症，医疗系统每年产生约100亿欧元的直接费用[13]。与此形成对比的是，健康保险公司一再质疑合格戒断治疗（QE）作为指南推荐的金标准疗法[4][10]。
