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Kraus L, Möckl J, Manthey J, Rovira P, Olderbak S, Rehm J. Trends in alcohol-attributable morbidity and mortality in Germany from 2000 to 2021: A modelling study. Drug Alcohol Rev 2024. [PMID: 39205426 DOI: 10.1111/dar.13928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION We aimed to assess: (i) trends in alcohol-specific - that is, fully attributable - morbidity and mortality in the German adult population aged 15-69 between 2000 and 2021; and (ii) changes in alcohol-attributable disease burden - that is, fully and partially alcohol-attributable categories - for 2006, 2012, 2018 and 2021. METHODS Morbidity data was pulled from hospitalisation and rehabilitation statistics and mortality data was pulled from the causes of death registry. Alcohol use, adjusted for unrecorded consumption, was estimated using the Epidemiological Survey of Substance Abuse and triangulated with per capita consumption from annual sales data. For major disease categories, alcohol-attributable fractions were estimated for males and females by age groups (15-29, 30-49, 50-69 years) using the comparative risk assessment methodology. RESULTS For males and females, the age-standardised rate of alcohol-specific morbidity peaked in 2012 and decreased thereafter showing a steep decline from 2019 to 2021. The rates of alcohol-specific mortality decreased constantly from 2000 to 2019 but increased from 2019 to 2021. Compared to 2006 the age-standardised alcohol-attributable morbidity and mortality rates in males and females were lower in 2021. For both sexes, the age-standardised alcohol-attributable morbidity and mortality rates and the proportions of morbidity/mortality rates relative to all-cause morbidity/mortality decreased between 2006 and 2021. DISCUSSION The declines in alcohol-attributable morbidity and mortality are in line with decreases in consumption and signal that the importance of alcohol in health service utilisation and mortality has weakened. Sex ratios in morbidity and mortality do not indicate a strong converging trend.
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Affiliation(s)
- Ludwig Kraus
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
- Centre of Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Justin Möckl
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jakob Manthey
- Centre of Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Pol Rovira
- Program on Substance Abuse & WHO Collaborating Centre, Public Health Agency of Catalonia, Barcelona, Spain
| | - Sally Olderbak
- IFT Institut für Therapieforschung, Centre for Mental Health and Addiction Research, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Jürgen Rehm
- Centre of Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Program on Substance Abuse & WHO Collaborating Centre, Public Health Agency of Catalonia, Barcelona, Spain
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Toronto, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität, Dresden, Germany
- Department of Psychiatry, Institute of Medical Science, & Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Fernández Castro I, Marcos Martín M, Novo Veleiro I. Alcohol consumption in elderly people. What is the real magnitude of the problem? Rev Clin Esp 2024:S2254-8874(24)00101-2. [PMID: 39038787 DOI: 10.1016/j.rceng.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/18/2024] [Indexed: 07/24/2024]
Abstract
The harmful effects of alcohol consumption have been well studied in the general population, but in the group of people over 80 years of age there is not much information regarding its relevance. It is estimated than 30%-40% of this population consumes alcohol regularly and around 10% engage in high-risk consumption. Furthermore, potential interactions between this substance and commonly consumed drugs in this age group, like oral antidiabetics, anticoagulants and antibiotics, may pose a risk of serious complications. In this sense, the aim of the present work was to analyze the magnitude of alcohol consumption within people over 80 years of age and the impact it has on their health. A narrative review of the available literature on the topic was carried out, which showed that alcohol consumption in people over 80 years of age is common in our environment and is associated with multiple complications and the development of different pathologies. The correct quantification of alcohol consumption in very elderly people must be integrated into the daily clinical practice of Medicine in general and Internal Medicine in particular.
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Affiliation(s)
- I Fernández Castro
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain
| | - M Marcos Martín
- Servicio de Medicina Interna, Hospital Universitario de Salamanca, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain; Departamento de Medicina, Universidad de Salamanca, Spain
| | - I Novo Veleiro
- Servicio de Hospitalización a Domicilio, Complejo Hospitalario Universitario de Santiago de Compostela, Spain; Grupo de Trabajo de Alcohol y otras Drogas. Sociedad Española de Medicina Interna, Spain; Departamento de Medicina, Universidad de Santiago de Compostela, Spain.
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Kools N, Dekker GG, Kaijen BAP, Meijboom BR, Bovens RHLM, Rozema AD. Interdisciplinary collaboration in the treatment of alcohol use disorders in a general hospital department: a mixed-method study. Subst Abuse Treat Prev Policy 2022; 17:59. [PMID: 35962380 PMCID: PMC9372961 DOI: 10.1186/s13011-022-00486-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 12/17/2022] Open
Abstract
Background Interdisciplinary collaborations (i.e., where various disciplines work coordinated and interdependently toward shared goals) are stated to yield higher team effectiveness than multidisciplinary approaches (i.e., where various disciplines work in parallel within their professional boundaries) in somatic health care settings. Nevertheless, research is lacking on interdisciplinary approaches for alcohol use disorder (AUD) treatment of hospitalized patients as these types of approaches are still uncommon. This study aims to evaluate an innovative interdisciplinary AUD treatment initiative at a general hospital department by 1) identifying which and to what extent network partners are involved and 2) to explore how network partners experienced the interdisciplinary collaboration. Methods A mixed-method study was conducted, using 1) measures of contact frequency and closeness in a social network analysis and 2) semi-structured interviews, which were analyzed thematically. Respondents were network partners of an interdisciplinary collaboration in a general hospital department, initially recruited by the collaborations’ project leader. Results The social network analysis identified 16 network partners, including a ‘core’ network with five central network partners from both inside and outside the hospital. The project leader played an important central role in the network and the resident gastroenterologist seemed to have a vulnerable connection within the network. Closeness between network partners was experienced regardless of frequency of contact, although this was especially true for the ‘core’ group that (almost) always consisted of the same network partners that were present at biweekly meetings. Interview data showed that presence of the ‘core’ network partners was reported crucial for an efficient collaboration. Respondents desired knowledge about the collaborations’ effectiveness, and one structured protocol with working procedures, division of responsibilities and agreements on information sharing and feedback. Conclusions The design of this interdisciplinary collaboration has potential in improving the treatment of hospital patients with AUD and was evaluated positively by the involved network partners. Interdisciplinary collaborations may offer a critical solution to increase treatment rates of patients with AUD and should be adopted in hospitals on a larger scale. Research towards the effectiveness of interdisciplinary collaborations in the treatment of hospitalized patients with AUD is needed.
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Chen CY, Lin CC, Kao JT, Yeh WL, Lin CY, Tsai YF. Predicting Hazardous Alcohol Drinking Behaviors in Family Members of Hazardous Alcohol-Drinker Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095497. [PMID: 35564892 PMCID: PMC9105135 DOI: 10.3390/ijerph19095497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 12/04/2022]
Abstract
Family members of hazardous or harmful alcohol drinkers suffer many consequences of their relative’s alcohol-drinking behaviors and risk developing their own hazardous alcohol drinking behaviors. Studies of alcohol-related healthcare problems have mainly focused on patients, with few studies on their family members. This cross-sectional study explored factors predicting hazardous alcohol drinking behaviors in family members of hazardous alcohol-drinker patients. Participants were recruited from four randomly chosen hospitals in Taiwan. Data were collected using self-report questionnaires on family members’ alcohol use, perceived stress, coping mechanisms, social support, health, quality of life, protective factors against hazardous alcohol drinking, facilitative factors for hazardous alcohol drinking, and demographics. The 318 family members who participated in this study were divided by their Chinese-version Alcohol Use Disorders Identification Test scores into two groups: hazardous alcohol drinkers (score ≥ 8) and non-hazardous alcohol drinkers (score < 8). Significant factors predicting hazardous alcohol drinking behaviors were found by logistic regression to be the frequency of using general coping mechanisms (OR = 1.29, p < 0.01), the frequency of using strategies to cope with patients’ drinking-related behaviors (OR = 0.89, p < 0.01), factors protecting against hazardous alcohol drinking (OR = 0.76, p < 0.01) and factors facilitating hazardous alcohol drinking (OR = 1.52, p < 0.01). Interventions should be designed for family members of hazardous alcohol drinkers to address these four significant predictors.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City 204, Taiwan;
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
| | - Chen-Chun Lin
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
- Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan
| | - Jung-Ta Kao
- School of Medicine, College of Medicine, China Medical University, Taichung City 404, Taiwan;
- Division of Hepato-Gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung City 404, Taiwan
| | - Wen-Ling Yeh
- College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan; (C.-C.L.); (W.-L.Y.)
- Department of Orthopedics, Lotung Poh-Ai Hospital, Luodong Township, Yilan County 265, Taiwan
| | - Chiao-Yun Lin
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan City 333, Taiwan;
| | - Yun-Fang Tsai
- Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung City 204, Taiwan;
- School of Nursing, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Taoyuan City 333, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 333, Taiwan
- Correspondence: ; Tel.: +886-3-2118800 (ext. 3204); Fax: +886-3-2118868
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Finanger T, Vaaler AE, Spigset O, Aamo TO, Andreassen TN, Gråwe RW, Skråstad RB. Identification of unhealthy alcohol use by self-report and phosphatidylethanol (PEth) blood concentrations in an acute psychiatric department. BMC Psychiatry 2022; 22:286. [PMID: 35449039 PMCID: PMC9026645 DOI: 10.1186/s12888-022-03934-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of standard screening methods could improve the detection rate of unhealthy alcohol use in patients admitted to psychiatric acute and emergency departments. The aim of the present study was to investigate the ability of the alcohol biomarker phosphatidylethanol (PEth) to identify patients with high levels of alcohol consumption prior to admission. METHODS The data were prospectively collected at admittance to an acute psychiatric department in the period January 2016 to June 2017. A blood sample for the analysis of PEth was available from 177 patients. We compared the PEth concentrations with the Alcohol Use Disorders Identification Test (AUDIT) scores during the hospital stay, and psychiatric diagnoses at discharge. RESULTS A total of 45.8% of the patients had a PEth concentration ≥ 0.03 μmol/L, indicating significant alcohol consumption. AUDIT scores consistent with unhealthy alcohol use were present in 51.7%. There was a significant positive correlation between PEth concentrations and AUDIT scores (r = 0.631, p < 0.001). PEth was above the detection limit of 0.03 μmol/L in 19% of those reporting an average daily intake of zero alcohol units per day during the last week before admission. PEth concentrations were significantly higher among those with an alcohol diagnosis than among those without such a diagnosis (0.82 μmol/L vs. 0.09 μmol/L, p = 0.001). CONCLUSION PEth provides supplementary information on recent alcohol consumption in a psychiatric population and would be particularly helpful in patients unable or unwilling to give such information at admission.
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Affiliation(s)
- Trine Finanger
- Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Klostergata 48, 7030, Trondheim, Norway. .,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology - NTNU, Trondheim, Norway.
| | - Arne Einar Vaaler
- grid.52522.320000 0004 0627 3560Department of Acute Psychiatry, Division of Mental Health, St. Olav University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway
| | - Olav Spigset
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trond Oskar Aamo
- grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Trine Naalsund Andreassen
- grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
| | - Rolf Wilhelm Gråwe
- grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Research and Development, Division of Mental Health, St. Olav University Hospital, Trondheim, Norway
| | - Ragnhild Bergene Skråstad
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology – NTNU, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway
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Lin Y, Sharma B, Thompson HM, Boley R, Perticone K, Chhabra N, Afshar M, Karnik NS. External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients. Addiction 2022; 117:925-933. [PMID: 34729829 PMCID: PMC9296269 DOI: 10.1111/add.15730] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/13/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Unhealthy alcohol use (UAU) is one of the leading causes of global morbidity. A machine learning approach to alcohol screening could accelerate best practices when integrated into electronic health record (EHR) systems. This study aimed to validate externally a natural language processing (NLP) classifier developed at an independent medical center. DESIGN Retrospective cohort study. SETTING The site for validation was a midwestern United States tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. PARTICIPANTS/CASES Unplanned admissions of adult patients between October 23, 2017 and December 31, 2019, with EHR documentation of manual alcohol screening were included in the cohort (n = 57 605). MEASUREMENTS The Alcohol Use Disorders Identification Test (AUDIT) served as the reference standard. AUDIT scores ≥5 for females and ≥8 for males served as cases for UAU. To examine error in manual screening or under-reporting, a post hoc error analysis was conducted, reviewing discordance between the NLP classifier and AUDIT-derived reference. All clinical notes excluding the manual screening and AUDIT documentation from the EHR were included in the NLP analysis. FINDINGS Using clinical notes from the first 24 hours of each encounter, the NLP classifier demonstrated an area under the receiver operating characteristic curve (AUCROC) and precision-recall area under the curve (PRAUC) of 0.91 (95% CI = 0.89-0.92) and 0.56 (95% CI = 0.53-0.60), respectively. At the optimal cut point of 0.5, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 0.66 (95% CI = 0.62-0.69), 0.98 (95% CI = 0.98-0.98), 0.35 (95% CI = 0.33-0.38), and 1.0 (95% CI = 1.0-1.0), respectively. CONCLUSIONS External validation of a publicly available alcohol misuse classifier demonstrates adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
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Affiliation(s)
- Yiqi Lin
- Rush Medical CollegeRush UniversityChicagoILUSA
| | - Brihat Sharma
- Department of Psychiatry and Behavioral SciencesRush Medical College, Rush UniversityChicagoILUSA
| | - Hale M. Thompson
- Department of Psychiatry and Behavioral SciencesRush Medical College, Rush UniversityChicagoILUSA
| | - Randy Boley
- Department of Psychiatry and Behavioral SciencesRush Medical College, Rush UniversityChicagoILUSA
| | | | - Neeraj Chhabra
- Department of Emergency Medicine, Rush Medical CollegeRush UniversityChicagoILUSA,Department of Emergency MedicineJohn. H. Stroger, Jr. Hospital of Cook CountyChicagoILUSA
| | - Majid Afshar
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public HealthUniversity of WisconsinMadisonWIUSA
| | - Niranjan S. Karnik
- Rush Medical CollegeRush UniversityChicagoILUSA,Department of Psychiatry and Behavioral SciencesRush Medical College, Rush UniversityChicagoILUSA
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Alonso-Ortiz MB, Novo-Veleiro I. Alcohol en el paciente pluripatológico. Med Clin (Barc) 2022; 158:422-423. [DOI: 10.1016/j.medcli.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022]
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Kools N, van de Goor I, Bovens RHLM, van de Mheen D, Rozema AD. Impeding and facilitating factors for the implementation of alcohol interventions in hospitals: a qualitative and exploratory study among Dutch healthcare professionals. BMC Health Serv Res 2022; 22:6. [PMID: 34974830 PMCID: PMC8722137 DOI: 10.1186/s12913-021-07412-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Non-moderated alcohol use is more prevalent among hospitalized patients compared to the general population. However, many hospitals fail to find and intervene with people with alcohol problems. We aimed to conduct an exploration of impeding and facilitating factors experienced by healthcare professionals in implementation of alcohol interventions in Dutch general hospitals. In addition, we explored the alcohol interventions used in the selected hospitals and involved stakeholders. Methods Through a qualitative study, semi-structured telephone interviews were conducted with twenty healthcare professionals working in or in collaboration with six different general hospitals. Results Healthcare professionals indicated impeding and facilitating factors in the areas of motivation, knowledge and skills, patient characteristics, protocol, internal and external collaboration/support, resources, role suitability and societal support. Five different categories of approaches to identify and intervene with non-moderated alcohol use and 18 involved stakeholders from both inside and outside the hospital were found. Conclusions Implementation of alcohol interventions for patients in Dutch general hospitals still seems to be in its infancy. Respondents emphasized the importance of one clear protocol on how to tackle alcohol problems within their hospital, repeated training on alcohol-related knowledge and skills, (clinical) “champions” that support healthcare professionals and developing and maintaining collaborations with stakeholders within and outside the hospital.
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Affiliation(s)
- Nathalie Kools
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000 LE, Tilburg, The Netherlands.
| | - Ien van de Goor
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000 LE, Tilburg, The Netherlands
| | - Rob H L M Bovens
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000 LE, Tilburg, The Netherlands
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000 LE, Tilburg, The Netherlands
| | - Andrea D Rozema
- Tranzo Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, PO box 90153, 5000 LE, Tilburg, The Netherlands
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Zhou DJ, Samson KK, Joseph N, Fahad I, Purbaugh MV, Villafuerte-Trisolini BJ, Kodali N, Guda P, Grogan W, Mukherjee U, Kedar S. Thiamine supplementation in hospitalized patients with altered mental status: does it help? Hosp Pract (1995) 2021; 50:27-36. [PMID: 34875959 DOI: 10.1080/21548331.2021.2014737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe thiamine-prescribing patterns and to study the association of thiamine supplementation with clinical outcomes in hospitalized patients with altered mental status (AMS). METHODS We conducted a retrospective cohort study of all adult hospitalized patients with AMS with index admission in calendar year 2017. We studied the association of a) supplemental thiamine and b) timing of thiamine relative to glucose, with hospital outcomes - length of stay (LOS), 90-day readmission rates, and mortality rates - using linear, logistic, and extended Cox models, respectively. We also modeled association of supplemental thiamine on time to resolution of AMS using extended Cox models in patients admitted with AMS. RESULTS Of 985 patients, 178 (18%) received thiamine, including 123 (12.5%) who received thiamine before, with, or without glucose (thiamine first). We identified 365 (37%) patients who received intravenous glucose before or without thiamine (glucose first). We found that patients who received glucose first had longer LOS and higher rate of in-hospital deaths compared to those who did not. Patients who received thiamine supplementation had longer LOS compared to those who did not. There were no significant differences in other hospital outcomes or AMS resolution by discharge compared to their respective reference groups. CONCLUSION Although thiamine supplementation was not associated with better hospital or cognitive outcomes, we do not have enough evidence to suggest a change in current practice. Thiamine must be administered prior to glucose in hospitalized patients with AMS.
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Affiliation(s)
- Daniel J Zhou
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kaeli K Samson
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Navya Joseph
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ismail Fahad
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Matthew V Purbaugh
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Neeharica Kodali
- Electronic Health Record Data Access Core, University of Nebraska Medical Center, Omaha, NE, USA
| | - Purnima Guda
- Electronic Health Record Data Access Core, University of Nebraska Medical Center, Omaha, NE, USA
| | - Wendie Grogan
- Department of Pharmaceutical Services, Nebraska Medicine, Omaha, NE, USA
| | - Urmila Mukherjee
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sachin Kedar
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
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Tevik K, Bergh S, Selbæk G, Johannessen A, Helvik AS. A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults. PLoS One 2021; 16:e0261292. [PMID: 34914759 PMCID: PMC8675766 DOI: 10.1371/journal.pone.0261292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. Methods A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. Results Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. Conclusion No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.
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Affiliation(s)
- Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- * E-mail:
| | - Sverre Bergh
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Geir Selbæk
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Vestfold, Norway
| | - Anne-S. Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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To D, Sharma B, Karnik N, Joyce C, Dligach D, Afshar M. Validation of an alcohol misuse classifier in hospitalized patients. Alcohol 2020; 84:49-55. [PMID: 31574300 DOI: 10.1016/j.alcohol.2019.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/10/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Current modes of identifying alcohol misuse in hospitalized patients rely on self-report questionnaires and diagnostic codes that have limitations, including low sensitivity. Information in the clinical notes of the electronic health record (EHR) may further augment the identification of alcohol misuse. Natural language processing (NLP) with supervised machine learning has been successful at analyzing clinical notes and identifying cases of alcohol misuse in trauma patients. METHODS An alcohol misuse NLP classifier, previously developed on trauma patients who completed the Alcohol Use Disorders Identification Test, was validated in a cohort of 1000 hospitalized patients at a large, tertiary health system between January 1, 2007 and September 1, 2017. The clinical notes were processed using the clinical Text Analysis and Knowledge Extraction System. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for alcohol misuse were used during annotation of the medical records in our validation dataset. RESULTS The alcohol misuse classifier had an area under the receiver operating characteristic curve of 0.91 (95% CI 0.90-0.93) in the cohort of hospitalized patients. The sensitivity, specificity, positive predictive value, and negative predictive value were 0.88 (95% CI 0.85-0.90), 0.78 (95% CI 0.74-0.82), 0.85 (95% CI 0.82-0.87), and 0.82 (95% CI 0.78-0.86), respectively. The Hosmer-Lemeshow Test (p = 0.13) demonstrates good model fit. Additionally, there was a dose-dependent response in alcohol consumption behaviors across increasing strata of predicted probabilities for alcohol misuse. CONCLUSION The alcohol misuse NLP classifier had good discrimination and test characteristics in hospitalized patients. An approach using the clinical notes with NLP and supervised machine learning may better identify alcohol misuse cases than conventional methods solely relying on billing diagnostic codes.
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Affiliation(s)
- Daniel To
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA
| | - Brihat Sharma
- Department of Computer Science, Loyola University Chicago, Chicago, IL, USA
| | - Niranjan Karnik
- Department of Psychiatry & Behavioral Sciences, Rush Medical College, Rush University, Chicago, IL, USA
| | - Cara Joyce
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA; Center for Health Outcomes and Informatics Research, Loyola University Chicago, Maywood, IL, USA
| | - Dmitriy Dligach
- Department of Computer Science, Loyola University Chicago, Chicago, IL, USA; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA; Center for Health Outcomes and Informatics Research, Loyola University Chicago, Maywood, IL, USA
| | - Majid Afshar
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA; Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA; Center for Health Outcomes and Informatics Research, Loyola University Chicago, Maywood, IL, USA.
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12
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Harmful alcohol use among acutely ill hospitalized medical patients in Oslo and Moscow: A cross-sectional study. Drug Alcohol Depend 2019; 204:107588. [PMID: 31590131 DOI: 10.1016/j.drugalcdep.2019.107588] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 07/03/2019] [Accepted: 08/09/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND The aim was to estimate the prevalence of harmful alcohol use in relation to socio-demographic characteristics among acutely ill medical patients, and examine identification measures of alcohol use, including the alcohol biomarker phosphatidylethanol 16:0/18:1 (PEth). METHODS A cross-sectional study, lasting one year at one hospital in Oslo, Norway and one in Moscow, Russia recruiting acute medically ill patients (≥ 18 years), able to give informed consent. Self-reported data on socio-demographics, mental distress (Symptom Check List-5), alcohol use (Alcohol Use Disorder Identification Test-4 (AUDIT-4) and alcohol consumption past 24 h were collected. PEth and alcohol concentration were measured in whole blood. RESULTS Of 5883 participating patients, 19.2% in Moscow and 21.1% in Oslo were harmful alcohol users, measured by AUDIT-4, while the prevalence of PEth-positive patients was lower: 11.4% in Oslo, 14.3% in Moscow. Men in Moscow were more likely to be harmful users by AUDIT-4 and PEth compared to men in Oslo, except of those being ≥ 71 years. Women in Oslo were more likely to be harmful users compared to those in Moscow by AUDIT-4, but not by PEth for those aged < 61 years. CONCLUSIONS The prevalence of harmful alcohol use was high at both study sites. The prevalence of harmful alcohol use was lower when assessed by PEth compared to AUDIT-4. Thus, self-reporting was the most sensitive measure in revealing harmful alcohol use among all groups except for women in Moscow. Hence, screening and identification with objective biomarkers and self-reporting might be a method for early intervention.
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13
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Mai Loan NT, Bertino JS, Kittisopee T. Alcohol use disorder and alcohol withdrawal syndrome in Vietnamese hospitalized patients. Alcohol 2019; 78:51-56. [PMID: 30660599 DOI: 10.1016/j.alcohol.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 12/18/2018] [Accepted: 01/10/2019] [Indexed: 11/26/2022]
Abstract
AIMS To identify the extent to which patients admitted to a general hospital in Vietnam meet the criteria for risky alcohol drinking, alcohol use disorder (AUD), and alcohol withdrawal syndrome (AWS), describe problems and behavior of alcohol use such as types and quantity of alcohol drinking in a hospitalized population in Vietnam, and investigate the association among age, disease-related factors, and alcohol consumption with AWS. METHODS This study was conducted prospectively in 1340 patients admitted to a general hospital. All patients were screened for risky alcohol drinking. Risky alcohol drinkers were assessed by using the Alcohol Use Disorder Identification Test (AUDIT) to identify AUD patients. The diagnosis of AWS was based on criteria defined by Diagnostic and Statistical Manual of Mental Disorders, version 5. The AWS scale was used to quantitate AWS severity level. RESULTS Prevalence of risky alcohol drinkers, AUD patients, and AWS patients among hospitalized patients was 15.5%, 13.1%, and 7.3%, respectively. All of the AUD and AWS patients were male. The majority of risky alcohol drinkers, patients with AUD, and patients with AWS were 40-60-year-old men. Almost all patients (98.3%) drank homemade alcohol. Hospitalized patients were more likely to develop AWS if they had liver disease or past experience with AWS. CONCLUSIONS AUD and AWS are common in hospitalized patients. Formulating a protocol to identify and care for patients with alcohol-related disorders is urgent.
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Santos SGRD, Mattos AA, Guimarães MM, Boger BDS, Coral GP. Alcohol Consumption Influences Clinical Outcome in Patients Admitted to a Referral Center for Liver Disease. Ann Hepatol 2019; 17:470-475. [PMID: 29735785 DOI: 10.5604/01.3001.0011.7391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND AIM Excessive alcohol consumption is a public health concern worldwide and has been associated with high mortality rates. This study aimed to determine the prevalence of alcohol consumption and its influence on the prognosis of hospitalized cirrhotic patients in a tertiary care hospital. MATERIAL AND METHODS We reviewed the medical records of all patients with hepatic cirrosis admitted between January 2009 and December 2014, in a referral center for liver disease in southern Brazil. Data on clinical outcomes, associated conditions, infections, and mortality were collected and compared between alcoholic and nonalcoholic patients. RESULTS The sample consisted of 388 patients; 259 (66.7%) were men. One hundred fifty-two (39.2%) were classified as heavy use of alcohol. Most alcoholic patients were men (n = 144; 94.7%). Mean age was 55.6 ± 8.9 years. Hepatic decompensations and infections were more prevalent in alcoholic patient. Spontaneous bacterial peritonitis and respiratory tract infection accounted for most of the infections. Excessive alcohol consumption was associated with mortality (P = 0.009) in multivariate analysis. CONCLUSION On the present study, the prevalence of heavy use of alcohol was high and associated with a poorer prognosis in hospitalized cirrhotic patients, increasing the risk of infection and death.
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Affiliation(s)
- Suyan G R Dos Santos
- Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Angelo A Mattos
- Federal University of Health Sciences of Porto Alegre (UFCSPA), Brazil
| | - Marcela M Guimarães
- Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Bibiana de S Boger
- Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Gabriela P Coral
- Postgraduate Program in Medicine: Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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15
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Justice AC, Smith RV, Tate JP, McGinnis K, Xu K, Becker WC, Lee KY, Lynch K, Sun N, Concato J, Fiellin DA, Zhao H, Gelernter J, Kranzler HR. AUDIT-C and ICD codes as phenotypes for harmful alcohol use: association with ADH1B polymorphisms in two US populations. Addiction 2018; 113:2214-2224. [PMID: 29972609 PMCID: PMC6226338 DOI: 10.1111/add.14374] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/31/2018] [Accepted: 06/28/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Longitudinal electronic health record (EHR) data offer a large-scale, untapped source of phenotypical information on harmful alcohol use. Using established, alcohol-associated variants in the gene that encodes the enzyme alcohol dehydrogenase 1B (ADH1B) as criterion standards, we compared the individual and combined validity of three longitudinal EHR-based phenotypes of harmful alcohol use: Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) trajectories; mean age-adjusted AUDIT-C; and diagnoses of alcohol use disorder (AUD). DESIGN With longitudinal EHR data from the Million Veteran Program (MVP) linked to genetic data, we used two population-specific polymorphisms in ADH1B that are associated strongly with AUD in African Americans (AAs) and European Americans (EAs): rs2066702 (Arg369Cys, AAs) and rs1229984 (Arg48His, EAs) as criterion measures. SETTING United States Department of Veterans Affairs Healthcare System. PARTICIPANTS A total of 167 721 veterans (57 677 AAs and 110 044 EAs; 92% male, mean age = 63 years) took part in this study. Data were collected from 1 October 2007 to 1 May 2017. MEASUREMENTS Using all AUDIT-C scores and AUD diagnostic codes recorded in the EHR, we calculated age-adjusted mean AUDIT-C values, longitudinal statistical trajectories of AUDIT-C scores and ICD-9/10 diagnostic groupings for AUD. FINDINGS A total of 19 793 AAs (34.3%) had one or two minor alleles at rs2066702 [minor allele frequency (MAF) = 0.190] and 6933 EAs (6.3%) had one or two minor alleles at rs1229984 (MAF = 0.032). In both populations, trajectories and age-adjusted mean AUDIT-C were correlated (r = 0.90) but, when considered separately, highest score (8+ versus 0) of age-adjusted mean AUDIT-C demonstrated a stronger association with the ADH1B variants [adjusted odds ratio (aOR) 0.54 in AAs and 0.37 in AAs] than did the highest trajectory (aOR 0.71 in AAs and 0.53 in EAs); combining AUDIT-C metrics did not improve discrimination. When age-adjusted mean AUDIT-C score and AUD diagnoses were considered together, age-adjusted mean AUDIT-C (8+ versus 0) was associated with lower odds of having the ADH1B minor allele than were AUD diagnostic codes: aOR = 0.59 versus 0.86 in AAs and 0.48 versus 0.68 in EAs. These independent associations combine to yield an even lower aOR of 0.51 for AAs and 0.33 for EAs. CONCLUSIONS The age-adjusted mean AUDIT-C score is associated more strongly with genetic polymorphisms of known risk for alcohol use disorder than are longitudinal trajectories of AUDIT-C or AUD diagnostic codes. AUD diagnostic codes modestly enhance this association.
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Affiliation(s)
- Amy C. Justice
- Yale School of Medicine, New Haven CT 06515,Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516,Yale School of Public Health, New Haven CT 06515
| | - Rachel V. Smith
- University of Louisville School of Nursing, Louisville, KY 40202
| | | | - Kathleen McGinnis
- Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Ke Xu
- Yale School of Medicine, New Haven CT 06515,Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - William C. Becker
- Yale School of Medicine, New Haven CT 06515,Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Kuang-Yao Lee
- Department of Statistical Science, Temple University, Philadelphia, PA 19122
| | - Kevin Lynch
- VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA 19104,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
| | - Ning Sun
- Yale School of Medicine, New Haven CT 06515,Yale School of Public Health, New Haven CT 06515
| | - John Concato
- Yale School of Medicine, New Haven CT 06515,Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - David A. Fiellin
- Yale School of Medicine, New Haven CT 06515,Yale School of Public Health, New Haven CT 06515
| | - Hongyu Zhao
- Yale School of Medicine, New Haven CT 06515,Yale School of Public Health, New Haven CT 06515
| | - Joel Gelernter
- Yale School of Medicine, New Haven CT 06515,Veterans Affairs Connecticut Healthcare System, West Haven, CT 06516
| | - Henry R. Kranzler
- VISN 4 MIRECC, Crescenz VAMC, Philadelphia, PA 19104,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104
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16
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Tasas de incidencia de ingresos asociados a síndrome de abstinencia alcohólica en España: análisis del conjunto mínimo básico de datos 1999-2010. Med Clin (Barc) 2018; 151:103-108. [DOI: 10.1016/j.medcli.2017.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 10/30/2017] [Accepted: 11/02/2017] [Indexed: 11/23/2022]
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17
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Hsu KY, Tsai YF, Huang CC, Yeh WL, Chang KP, Lin CC, Chen CY, Lee HL. Tobacco-Smoking, Alcohol-Drinking, and Betel-Quid-Chewing Behaviors: Development and Use of a Web-Based Survey System. JMIR Mhealth Uhealth 2018; 6:e142. [PMID: 29891467 PMCID: PMC6018239 DOI: 10.2196/mhealth.9783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/12/2018] [Accepted: 05/08/2018] [Indexed: 12/28/2022] Open
Abstract
Background Smoking tobacco, drinking alcohol, and chewing betel quid are health-risk behaviors for several diseases, such as cancer, cardiovascular disease, and diabetes, with severe impacts on health. However, health care providers often have limited time to assess clients’ behaviors regarding smoking tobacco, drinking alcohol, and chewing betel quid and intervene, if needed. Objective The objective of this study was to develop a Web-based survey system; determine the rates of tobacco-smoking, alcohol-drinking, and betel-quid-chewing behaviors; and estimate the efficiency of the system (time to complete the survey). Methods Patients and their family members or friends were recruited from gastrointestinal medical–surgical, otolaryngology, orthopedics, and rehabilitation clinics or wards at a medical center in northern Taiwan. Data for this descriptive, cross-sectional study were extracted from a large series of research studies. A Web-based survey system was developed using a Linux, Apache, MySQL, PHP stack solution. The Web survey was set up to include four questionnaires: the Chinese-version Fagerstrom Tolerance Questionnaire, the Chinese-version Alcohol Use Disorders Identification Test, the Betel Nut Dependency Scale, and a sociodemographic form with several chronic diseases. After the participants completed the survey, the system automatically calculated their score, categorized their risk level for each behavior, and immediately presented and explained their results. The system also recorded the time each participant took to complete the survey. Results Of 782 patient participants, 29.6% were addicted to nicotine, 13.3% were hazardous, harmful, or dependent alcohol drinkers, and 1.5% were dependent on chewing betel quid. Of 425 family or friend participants, 19.8% were addicted to nicotine, 5.6% were hazardous, harmful, or dependent alcohol drinkers, and 0.9% were dependent on chewing betel quid. Regarding the mean time to complete the survey, patients took 7.9 minutes (SD 3.0; range 3-20) and family members or friends took 7.7 minutes (SD 2.8; range 3-18). Most of the participants completed the survey within 5-10 minutes. Conclusions The Web-based survey was easy to self-administer. Health care providers can use this Web-based survey system to save time in assessing these risk behaviors in clinical settings. All smokers had mild-to-severe nicotine addiction, and 5.6%-12.3% of patients and their family members or friends were at risk of alcohol dependence. Considering that these three behaviors, particularly in combination, dramatically increase the risk of esophageal cancer, appropriate and convenient interventions are necessary for preserving public health in Taiwan.
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Affiliation(s)
- Kuo-Yao Hsu
- Division of Orthopedic Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan.,College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Chu-Ching Huang
- Division of Natural Science, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan
| | - Wen-Ling Yeh
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Kai-Ping Chang
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Division of Head & Neck Surgery, Department of Otolaryngology, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan
| | - Chen-Chun Lin
- Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Ching-Yen Chen
- College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Hsiu-Lan Lee
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Nursing, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
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18
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Monte-Secades R, Blanco-Soto M, Díaz-Peromingo J, Sanvisens-Bergé A, Martín-González M, Barbosa A, Rosón-Hernández B, Tejero-Delgado M, Puerta-Louro R, Rabuñal-Rey R. Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome. Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2017.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Monte-Secades R, Blanco-Soto M, Díaz-Peromingo JA, Sanvisens-Bergé A, Martín-González MC, Barbosa A, Rosón-Hernández B, Tejero-Delgado MA, Puerta-Louro R, Rabuñal-Rey R. Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome. Rev Clin Esp 2017. [PMID: 28645616 DOI: 10.1016/j.rce.2017.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). MATERIAL AND METHODS A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens. RESULTS We studied 228 episodes of AWS in 219 patients. The mean age was 54.5 years (SD, 11.5), and 90.8% were men. AWS was the cause for hospitalisation in 39.9% of the patients. Some 27.1% of the cases presented seizures, and 32.4% presented delirium tremens. The daily quantity of alcohol ingested was 17.8 standard drink units (SD, 21.4), with 16.6 years of dependence (SD, 11.3). The pattern of alcohol abuse was regular in 82.8% of the patients. Some 38.4% of the patients were married or had a partner, and 45.6% had children. Some 72.7% of the patients were unemployed or retired. Some 68.5% had only completed primary studies. Some 4.8% consumed cannabis, 5.2% consumed cocaine and 3% consumed opioids. The independent variables related to complicated AWS were consumption of a drug other than alcohol (OR, 5.3; 95% CI 1.5-18.7), low education level (OR, 3.4; 95% CI 1.6-7.3) and hospitalisation for AWS (OR, 2.9; 95% CI 1.5-5.6). The model's receiver operating characteristic area was 0.718 (95% CI 0.643-0.793). CONCLUSIONS Concomitant drug abuse and a low educational level could help identify patients at risk of complicated AWS.
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Affiliation(s)
- R Monte-Secades
- Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, España.
| | - M Blanco-Soto
- Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria, Málaga, España
| | - J A Díaz-Peromingo
- Medicina Interna, Complejo Hospitalario Universitario,Santiago de Compostela, España
| | - A Sanvisens-Bergé
- Medicina Interna, Hospital Universitari Germans Trías i Pujol, Badalona, España
| | - M C Martín-González
- Medicina Interna, Hospital Universitario de Canarias, San Cristóbal de la Laguna
| | - A Barbosa
- Medicina Interna, Hospital Universitario, Salamanca, España
| | - B Rosón-Hernández
- Medicina Interna, Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | | | | | - R Rabuñal-Rey
- Medicina Interna, Hospital Universitario Lucus Augusti, Lugo, España
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Lin CC, Tsai YF, Yeh WL, Kao JT, Chen CY. Perceptions of problem-drinker patients' family members about their own hazardous-drinking behaviours in Chinese general hospitals: a qualitative study. BMC Psychiatry 2017; 17:189. [PMID: 28521730 PMCID: PMC5437516 DOI: 10.1186/s12888-017-1348-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive alcohol use has been associated with health, social and legal problems. Alcohol-related problems have been studied primarily in problem-drinker patients, with few studies on their family members, particularly about their own hazardous or harmful alcohol-drinking behaviours. METHOD In this qualitative descriptive study, participants were recruited from three hospitals randomly selected from northern and central Taiwan (2:1). Hazardous-drinker patients and their family members were screened using the Chinese version Alcohol Use Disorders Identification Test (scores ≥8 indicate harmful or hazardous drinkers). Data were collected in individual, audiotaped, in-depth interviews using an interview guide. Verbatim interview transcripts were analysed using ATLAS.ti, version WIN 7.0. RESULTS The sample of 35 family members with hazardous or harmful drinking behaviours perceived that their own alcohol-drinking behaviours were related to six major patterns: family habits, leisure activities with friends, work pressures, personal taste, a way to forget one's problems and to express happiness. CONCLUSION We recommend that programmes targeting harmful or hazardous drinking among problem-drinker patients' family members should educate participants about the standard amounts of alcohol in alcoholic beverages, recommended amounts of alcohol consumption for males and females, the long-term effects of excessive alcohol consumption; address sources of risk factors at work; offer strategies to resist social pressures to drink; and build positive strategies for coping with stress.
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Affiliation(s)
- Chen-Chun Lin
- 0000 0004 1756 1461grid.454210.6Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. .,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan. .,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan.
| | - Wen-Ling Yeh
- 0000 0004 1756 1461grid.454210.6Department of Traumatology Orthopedics, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Jung-Ta Kao
- 0000 0001 0083 6092grid.254145.3School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,0000 0004 0572 9415grid.411508.9Department of Internal Medicine, Division of Hepato-Gastroenterology, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Yen Chen
- 0000 0004 0639 2551grid.454209.eDepartment of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan ,grid.145695.aCollege of Medicine, Chang Gung University, Tao-Yuan, Taiwan
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Paljärvi T, Martikainen P, Vahtera J, Leinonen T, Mäkelä P. Hospital Admissions Before an Alcohol-Related Death Among Middle-Aged Employed Men and Women: A Cohort Study Using Routine Data. Alcohol Clin Exp Res 2016; 40:2161-2168. [PMID: 27534512 DOI: 10.1111/acer.13183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 07/18/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Due to lack of appropriate longitudinal data, relatively little is known about how and when persons who ultimately die due to alcohol-related causes interact with hospitals during the years before death. Using routinely collected nationwide data, we aimed to establish the timing and causes of all hospitalizations during a 10-year period before an alcohol-related death. METHODS We traced back the timing and causes of all hospitalizations occurring during a 10-year period before death among men and women (n = 2,981) who were aged 35 and in employment at study entry, and who died from alcohol-related causes at ages 45 to 54 in 1997 to 2007. The study data consisted of 80% of all persons living in Finland who died during the study period. Those who died at ages 45 to 54 without alcohol involvement were used as a reference group. RESULTS Persons who ultimately died from alcohol-related causes had on average 7 (mean 7.4, SD 9.9) hospital admissions, and they spent on average 56 days (mean 56.2, SD 105.1) in hospital during the study period. By the fifth year before death (from the year -10 to year -5), about three-fifths of these persons had been hospitalized due to any cause at least once, but less than one-third had a hospital admission with an alcohol-related diagnosis. Those who died without alcohol involvement had an average 9 hospital admissions (mean 9.3, SD 11.2), and they spent on average 81 days (mean 81.2, SD 163.9) in hospital during the study period. CONCLUSIONS The majority of employed middle-aged persons who ultimately died due to alcohol-related causes interacted with hospitals frequently and already several years before death. Additional research is warranted to evaluate whether enhanced patient management at hospitals targeted to this population could potentially reduce alcohol-related harms.
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Affiliation(s)
- Tapio Paljärvi
- Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland. .,Division of Population Medicine, University of Cardiff, Cardiff, United Kingdom.
| | | | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Finnish Institute of Occupational Health, Turku, Finland
| | - Taina Leinonen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Pia Mäkelä
- Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland
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Rosón B, Corbella X, Perney P, Santos A, Stauber R, Lember M, Arutyunov A, Ruza I, Vaclavik J, García L, Pujol R, Stauber R, Vogel W, Vaclavik J, Gajdová J, Smrzova A, Liberdová A, Cibickova L, Plasek J, Svarcova T, Salupere R, Lember M, Rosón B, Guillem MN, Fernández-Sola J, Zapatero A, Monte R, Puerta RB, Gamallo R, Durán C, Perney P, Ouakli A, Oziol E, Bastide D, Tourneaire P, Allard G, Cros H, Piala JM, Quere I, Condouret S, Ruža I, Funka K, Zarina L, Barata J, Gonsalves O, Santos A, Oliveira N, Yakushin S, Petrovicheva L, Sleptsov A, Arutyunov A, Mitkhat G, Marusenko I. Prevalence, Clinical Characteristics, and Risk Factors for Non-recording of Alcohol Use in Hospitals across Europe: The ALCHIMIE Study. Alcohol Alcohol 2016; 51:457-64. [DOI: 10.1093/alcalc/agv142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/30/2015] [Indexed: 11/14/2022] Open
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Monte-Secades R, Rabuñal-Rey R, Guerrero-Sande H. Síndrome de abstinencia alcohólica en pacientes hospitalizados. Rev Clin Esp 2015; 215:107-16. [DOI: 10.1016/j.rce.2014.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 10/15/2014] [Accepted: 11/10/2014] [Indexed: 10/24/2022]
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Inpatient alcohol withdrawal syndrome. Rev Clin Esp 2015. [DOI: 10.1016/j.rceng.2014.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kraus L, Pabst A, Piontek D, Gmel G, Shield KD, Frick H, Rehm J. Temporal Changes in Alcohol-Related Morbidity and Mortality in Germany. Eur Addict Res 2015; 21:262-72. [PMID: 25967383 DOI: 10.1159/000381672] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 03/14/2015] [Indexed: 11/19/2022]
Abstract
AIMS Trends in morbidity and mortality, fully or partially attributable to alcohol, for adults aged 18-64 were assessed for Germany. METHODS The underestimation of population exposure was corrected by triangulating survey data with per capita consumption. Alcohol-attributable fractions by sex and two age groups were estimated for major disease categories causally linked to alcohol. Absolute numbers, population rates and proportions relative to all hospitalizations and deaths were calculated. RESULTS Trends of 100% alcohol-attributable morbidity and mortality over thirteen and eighteen years, respectively, show an increase in rates of hospitalizations and a decrease in mortality rates. Comparisons of alcohol-attributable morbidity including diseases partially caused by alcohol revealed an increase in hospitalization rates between 2006 and 2012. The proportion of alcohol-attributable hospitalizations remained constant. Rates of alcohol-attributable mortality and the proportion among all deaths decreased. CONCLUSIONS The increasing trend in mortality due to alcohol until the mid-1990s has reversed. The constant proportion of all hospitalizations that were attributable to alcohol indicates that factors such as improved treatment and easier health care access may have influenced the general increase in all-cause morbidity. To further reduce alcohol-related mortality, efforts in reducing consumption and increasing treatment utilization are needed.
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Affiliation(s)
- Ludwig Kraus
- IFT Institut für Therapieforschung, München, Germany
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Gender-specific predictors of risky alcohol use among general hospital inpatients. Gen Hosp Psychiatry 2013; 35:9-15. [PMID: 23141029 DOI: 10.1016/j.genhosppsych.2012.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 08/15/2012] [Accepted: 08/21/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate sociodemographic-, living situation- and substance-related variables as predictors of current risky alcohol use for both female and male general hospital inpatients. METHOD The sample of 6050 female and 8282 male general hospital inpatients was recruited in 2002-2004. Using the Alcohol Use Disorder Identification Test-Consumption, they were assigned to four drinking groups: abstinent, moderate use, slightly increased use and notably increased use. Gender-specific predictors of group affiliation were determined using multivariate multinomial logistic regressions. RESULTS In both genders, younger age, rural living environment, the occurrence of lifetime alcohol use disorders (AUDs) and current tobacco smoking were positively associated with risky alcohol use. Higher education was positively associated with slightly and notably increased use for women. Living alone, being divorced/ widowed and being unemployed (relative risk ratios=1.4-1.7) were positively associated with notably increased use for men. In both genders, older age, less education and the occurrence of lifetime AUDs were positively associated with abstinence. CONCLUSIONS Higher educated women are likely to report risky alcohol use. Marriage may have a protective effect on level of alcohol use for men only. In addition to the implementation of routine alcohol screening, the examined data may provide cost-effective information that could be used to tailor interventions.
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Tsai YF, Lin YP, Tsai MC, Weng CE, Chen CY. Hazardous alcohol-drinking problems among a Chinese hospital patient population. J Adv Nurs 2012; 69:1819-28. [PMID: 23157429 DOI: 10.1111/jan.12043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2012] [Indexed: 11/28/2022]
Abstract
AIM The aims of this study were to explore: (1) the prevalence and predictors for hazardous alcohol-drinking problems; and (2) previous assessments and interventions for alcohol-drinking problems in hospitalized Chinese patients. BACKGROUND Alcohol is legally accessible and widely used in Taiwan, but few studies have addressed alcohol-drinking problems in hospital settings. DESIGN A cross-sectional design was used. METHOD Self-report data were collected in 2009 from 484 patients at five randomly selected general teaching hospitals. FINDINGS The prevalence of hazardous alcohol-drinking problems was 19·2%. Logistic regression analysis revealed that predictors for hazardous drinking problems were being male, smoking, and chewing betel quid. Only 29·1% of participants had been assessed for drinking problems in the past year. Only 38·7% of participants with drinking problems had received a drinking intervention in the past year. CONCLUSION These findings suggest that alcohol problems in Taiwanese general teaching hospitals are insufficiently assessed and targeted with interventions. Targeting high-risk groups in general teaching hospitals is important to prevent patients' drinking problems.
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Affiliation(s)
- Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
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Tsai YF, Chen CY, Lin YP, Tsai MC, Weng CE. Hazardous drinking problems in family members of problem-drinker patients in Chinese general hospitals. Gen Hosp Psychiatry 2012; 34:633-8. [PMID: 22771107 DOI: 10.1016/j.genhosppsych.2012.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 06/05/2012] [Accepted: 06/05/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To explore (1) the prevalence and risk factors for hazardous alcohol-drinking problems and (2) previous assessments and interventions for alcohol-drinking problems among family members of Chinese problem-drinker patients. METHOD Self-report data were collected from 517 family members of problem-drinker patients at five randomly selected general hospitals in Taiwan. RESULTS Family members' prevalence of hazardous alcohol-drinking problems was 13.3%. Logistic regression analysis revealed that risk factors for hazardous drinking were male gender, low education level, heart disease, smoking, and chewing betel quid. Only 11.8% of participants had been assessed for drinking problems in the past year. Only 5.2% of participants with drinking problems had received a drinking intervention in the past year. CONCLUSION Alcohol problems among family members of problem-drinker patients in Taiwanese general hospitals are insufficiently assessed and targeted with interventions. Targeting this high-risk group is important to prevent drinking problems in family members of problem-drinker patients.
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Affiliation(s)
- Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan.
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Murata A, Matsuda S, Kuwabara K, Ichimiya Y, Matsuda Y, Kubo T, Fujino Y, Fujimori K, Horiguchi H. Association between hospital volume and outcomes of elderly and non-elderly patients with acute biliary diseases: a national administrative database analysis. Geriatr Gerontol Int 2012; 13:731-40. [PMID: 22985177 DOI: 10.1111/j.1447-0594.2012.00938.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIM This study aimed to investigate the relationship between hospital volume and clinical outcomes of elderly and non-elderly patients with acute biliary diseases using data from a national administrative database. METHODS Overall, 26720 elderly and 33774 non-elderly patients with acute biliary diseases were referred to 820 hospitals in Japan. Hospital volume was categorized into three groups based on the case numbers during the study period: low-volume, medium-volume and high-volume. We compared the risk-adjusted length of stay (LOS) and in-hospital mortality in relation to hospital volume. These analyses were stratified according to the presence of invasive treatments for acute biliary diseases. RESULTS Multiple linear regression analyses showed that increased hospital volume was significantly associated with shorter LOS in both elderly and non-elderly patients with and without invasive treatments. Increased hospital volume was significantly associated with decreased relative risk of in-hospital mortality in elderly patients. The odds ratio for high-volume hospitals was 0.672 in elderly patients without invasive treatments (95% confidence interval [CI] 0.533-0.847, P=0.001) and 0.715 in those with invasive treatments (95% C, 0.566-0.904, P=0.005). However, no significant differences for in-hospital mortality were seen in non-elderly patients with and without invasive treatments. CONCLUSION This study has highlighted that higher volume hospitals significantly reduced LOS and in-hospital mortality for elderly patients with acute biliary diseases, but not non-elderly patients. The current results are of value for elderly healthcare policy decision-making, and highlight the need for further studies into the quality of care for elderly patients.
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Affiliation(s)
- Atsuhiko Murata
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
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