Phillips Thomas, Coleman Rachel, Coulton Simon
Centre for Addiction and Mental Health Research (CAMHR), University of Hull, East Yorkshire, Cottingham Road, Hull HU6 7RX, United Kingdom.
Alcohol Care Team, Department of Gastroenterology, Hull Royal Infirmary, Hull University Teaching Hospitals NHS Trust, East Yorkshire, Anlaby Road, Hull HU3 2JZ, United Kingdom.
Alcohol Alcohol. 2025 Mar 25;60(3). doi: 10.1093/alcalc/agaf022.
To examine predictors of 30-day readmissions to acute hospitals in England for patients treated for alcohol withdrawal (AW).
Retrospective cross-sectional analysis of routine hospital administrative data (i.e. Hospital Episode Statistics-Admitted Patient Care records) for adults admitted to non-specialist hospitals in England 2017-18.
AW admissions were associated with digestive, circulatory, respiratory, and endocrine disorders and were of short duration (median 3 days). Of the 19 588 completed AW admissions examined in 2017-18, 3957 (20.2%) resulted in readmission within 30 days. The strongest predictors of 30-day readmission were being no fixed abode (Adjusted Odds Ratio (AOR) 1.81, 95%CI 1.44-2.26), prior discharge against medical advice (AOR 1.57, 95%CI 1.40-1.77), and greater Charlson comorbidity index total score (AOR 1.02, 95%CI 1.02-1.03).
AW 30-day admissions are common and associated to complex case presentations that require high levels of community support on discharge. Hospital-based alcohol teams should prioritize strategies, which maximize medically managed AW, effective transitions to specialist community care including outreach teams and strong collaborations with physical and mental health outpatient services. Together with specialist initiatives within community mental health teams, assertive outreach, and homeless services 30-day readmissions may be minimized.
研究在英格兰因酒精戒断（AW）接受治疗的患者30天内再次入住急症医院的预测因素。
对2017 - 2018年入住英格兰非专科医院的成年患者的常规医院管理数据（即医院事件统计 - 入院患者护理记录）进行回顾性横断面分析。
酒精戒断入院与消化、循环、呼吸和内分泌疾病相关，且住院时间较短（中位数为3天）。在2017 - 2018年检查的19588例完成酒精戒断入院病例中，3957例（20.2%）在30天内再次入院。30天再入院的最强预测因素是无固定住所（调整优势比（AOR）1.81，95%置信区间1.44 - 2.26）、之前违反医嘱出院（AOR 1.57，95%置信区间1.40 - 1.77）以及较高的查尔森合并症指数总分（AOR 1.02，95%置信区间1.02 - 1.03）。
酒精戒断30天内入院情况常见，且与复杂的病例表现相关，出院时需要高水平的社区支持。医院的酒精治疗团队应优先制定策略，以最大限度地实现对酒精戒断的医学管理，有效过渡到专科社区护理，包括外展团队以及与身心健康门诊服务的紧密合作。与社区精神卫生团队内部的专科举措、积极外展和无家可归者服务相结合，30天再入院情况可能会降至最低。
