Predictors of 30-day readmission among those treated with alcohol withdrawal in acute hospitals in England.

AIMS

To examine predictors of 30-day readmissions to acute hospitals in England for patients treated for alcohol withdrawal (AW).

METHODS

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.

RESULTS

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).

DISCUSSION

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.