Healthcare Utilization in Medical Intensive Care Unit Survivors with Alcohol Withdrawal

Background Rehospitalization is an important and costly outcome that occurs commonly in several diseases encountered in the medical intensive care unit (ICU). Although alcohol use disorders are present in 40% of ICU survivors and alcohol withdrawal is the most common alcohol‐related reason for admis...

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Published in:Alcoholism, clinical and experimental research clinical and experimental research, 2013-09, Vol.37 (9), p.1536-1543
Main Authors: Clark, Brendan J., Keniston, Angela, Douglas, Ivor S., Beresford, Thomas, Macht, Madison, Williams, Andre, Jones, Jacqueline, Burnham, Ellen L., Moss, Marc
Format: Article
Language:English
Subjects:
Adult
Alcohol
Alcohol Use Disorder
Alcohol Withdrawal
Alcoholism - diagnosis
Alcoholism - epidemiology
Alcoholism - therapy
Cohort Studies
Comorbidity
Dual Diagnosis
Female
Humans
Intensive care
Intensive Care Unit
Intensive Care Units - trends
Intensive Care Units - utilization
Male
Middle Aged
Patient Acceptance of Health Care
Patient Readmission - trends
Rehospitalization
Retrospective Studies
Risk Factors
Studies
Substance Withdrawal Syndrome - diagnosis
Substance Withdrawal Syndrome - epidemiology
Substance Withdrawal Syndrome - therapy
Survivors
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Summary:Background Rehospitalization is an important and costly outcome that occurs commonly in several diseases encountered in the medical intensive care unit (ICU). Although alcohol use disorders are present in 40% of ICU survivors and alcohol withdrawal is the most common alcohol‐related reason for admission to an ICU, rates and predictors of rehospitalization have not been previously reported in this population. Methods We conducted a retrospective cohort study of medical ICU survivors with a primary or secondary discharge diagnosis of alcohol withdrawal using 2 administrative databases. The primary outcome was time to rehospitalization or death. Secondary outcomes included time to first emergency department or urgent care clinic visit in the subset of ICU survivors who were not rehospitalized. Cox proportional hazard models were adjusted for age, gender, race, homelessness, smoking, and payer source. Results Of 1,178 patients discharged from the medical ICU over the study period, 468 (40%) were readmitted to the hospital and 54 (4%) died within 1 year. Schizophrenia (hazard ratio 2.23, 95% CI 1.57, 3.34, p 
ISSN:0145-6008
1530-0277
DOI:10.1111/acer.12124