Alcohol-related Hospital Admissions Research Articles

The hidden impact of alcohol on young victims: an analysis of alcohol-related police offences resulting in hospitalisation

BackgroundAlcohol-related harm (ARH) is a significant public health concern affecting young individuals, particularly those involved in alcohol-related police incidents resulting in hospitalisation. However, the impact of alcohol on young victims remains under researched. This study aimed to identify the characteristics of offenders and victims involved in these incidents, analyse the types of offences, and understand the under-ascertainment of ARH in hospital records.MethodsA retrospective longitudinal study of 12–24-year-olds born between 1980 and 2005 was conducted using linked data from hospital admissions, emergency department presentations, and police incident records. Alcohol-related incidents were identified based on the attending officers’ opinions in the Western Australia Police’s Incident Management System (IMS). Logistic and log-binomial regression were utilised to analyse the factors associated with victimisation and under-ascertainment of ARH.ResultsOur study included 22,747 individuals (11,433 victims and 11,314 offenders) involved in alcohol-related police incidents, with a small majority of victims being female (53%, n = 6,074) and a large majority of offenders being male (84.3%, n = 9,532). Most victims did not receive a diagnosis of ARH (71%, n = 760). Women were 10 times more likely to have been a victim in ARH police incidents and 2 times more likely to have an undiagnosed alcohol-related hospital admission than men. Victims and offenders predominantly came from disadvantaged areas and major cities. Aboriginal individuals were overrepresented as both offenders and victims. A significant proportion of individuals experienced emergency department presentations or hospital admissions, with head injuries being the most common. Assault causing bodily harm was the most prevalent offence resulting in hospitalisation (66%, n = 2,018).ConclusionsThere is a noteworthy disparity between the quantity of hospital admissions attributed to alcohol-related incidents and the number of cases that are formally classified as ARH in the hospital system. This disparity highlights a more profound issue of substantial under-ascertainment or inadequate identification of ARH than previously acknowledged. Our findings justify the prioritisation of prevention strategies, beyond improvement in the documentation of alcohol-related hospitalisation. Considering the scale of the problem, and the underestimation of the burden of alcohol-related hospitalisation, a proportional increase in investment is necessary to achieve population-level reductions in ARH.

Alcohol-related emergency department presentations and hospital admissions around the time of minimum unit pricing in Ireland

BackgroundMinimum unit pricing (MUP) was recently introduced in Ireland to reduce alcohol-related harms. The size of the impact of alcohol on hospital emergency departments (EDs) in Ireland is poorly understood due to inconsistent alcohol screening and documentation. AimsWe sought to systematically characterise the volume, timing, and nature of alcohol-related presentations and admissions to a busy urban ED in Dublin, Ireland. MethodPatients presenting to the ED were assessed by a dedicated clinician during selected time periods before (Nov–Dec 2021) and after (Feb–Apr 2022) the introduction of MUP. A total of 725 interviews were conducted over 168 h in the ED. FindingsAlcohol consumption was a factor in 19.4% of ED presentations and in 17.3% of hospital admissions across the entire study period. A reduction in overall alcohol-related ED presentations was noted in the period following MUP, although it is not possible to conclude a direct effect. ConclusionAlcohol-related harm places a significant strain on EDs and hospitals, and the impact of MUP on hospital burden in Ireland merits further evaluation. Effective measures at local and population levels are urgently required to address this burden.

Does a local Alcohol Health Champion programme have a measurable impact on health and crime outcomes? A natural experiment evaluation of Communities in Charge of Alcohol (CICA) based on triangulation of methods.

Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol-related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation. Quantitative evaluation using four time series analytic methods (stepped-wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost-benefit analysis was carried out alongside the effectiveness analysis. The general public in Greater Manchester, UK, between 2010 and 2020. The primary outcome of interest was alcohol-related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti-social behaviour incidents. Triangulation of the results did not indicate any consistent effect on area-level alcohol-related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval -3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%. There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area-level health and crime outcomes in Greater Manchester, UK, within 3years of the programme start. The increase in alcohol-related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes.

Three years of minimum unit pricing in the Northern Territory, what does the evidence say?

Three years of minimum unit pricing in the Northern Territory, what does the evidence say?

Weighting of risk factors for low birth weight: a linked routine data cohort study in Wales, UK

ObjectiveGlobally, 20 million children are born with a birth weight below 2500 g every year, which is considered as a low birthweight (LBW) baby. This study investigates the contribution of...

Anti-osteoporosis medication dispensing by clinical commissioning groups in England - an ecological study of variability in practice and of the effect of the Covid-19 pandemic.

To investigate whether the rate of Anti-Osteoporosis Medication (AOM) dispensing was related to prevalence of risk factors and hip fracture incidence in the local population. The Open Prescribing database was used to analyse dispensed AOM at the level of Clinical Commissioning Groups (CCGs) in England. Male Healthy Life Expectancy (MHLE), Female Healthy Life Expectancy (FHLE), the prevalence of smoking and active adults, the incidence of hip fracture and of alcohol related hospital admissions, and local dispensing of a comparator drug (atorvastatin) were considered as predictor variables. Linear and multilinear regression were performed. Using atorvastatin as a comparator, AOM dispensing was compared after the start of the Covid-19 pandemic with the same quarter the previous year. Rates of AOM per 1000 people aged over 65 years in a CCG area varied between 379.2 and 1129.1, with a mean of 670.3. Population risk factors were individually related to the amount of AOM dispensed in an area. Collectively, local activity levels in adults (p=0.042) and local hip fracture incidence (p=0.003) were significantly negatively correlated with rates of AOM dispensed. Rates of alendronate dispensing fell significantly at the start of the Covid-19 pandemic (p < 0.001), whilst atorvastatin dispensing rates significantly increased (p < 0.001). Lower rates of AOM dispensing were seen in areas with a higher proportion of active adults and higher incidence of hip fracture. Multidisciplinary services should be developed to address this care gap with consideration given to local population risk factors. Community pharmacists are ideally placed to play a vital role in osteoporosis management.

Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study.

Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs). We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first. Denmark. Respondents (n = 4522) from a Danish national survey conducted in autumn 2011. Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder. During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31). Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.

Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012 and 2019.

SummaryBackgroundPublic health teams (PHTs) in England and Scotland engage to varying degrees in local alcohol licensing systems to try to reduce alcohol-related harms. No previous quantitative evidence is available on the effectiveness of this engagement. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes.Methods39 PHTs in England (n = 27) and Scotland (n = 12) were recruited (of 40 contacted) for diversity in licensing engagement level and region, with higher activity areas matched to lower activity areas. Each PHT's engagement in licensing for each 6 month period from April 2012 to March 2019 was quantified using a new measure (PHIAL) developed using structured interviews, documentary analyses, and expert consultation. Outcomes examined were ambulance callouts, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality and violent, sexual and public order offences. Timeseries were analysed using multivariable negative binomial mixed-effects models. Correlations were assessed between each outcome and 18-month average PHIAL score (primary metric), cumulative PHIAL scores and change in PHIAL scores. Additionally, 6-month lagged correlations were also assessed.FindingsThere was no clear evidence of any associations between the primary exposure metric and the public health or crime outcomes examined, nor between cumulative PHIAL scores or change in PHIAL score and any outcomes. There were no significant associations in England or Scotland when analysed separately or between outcomes and lagged exposure metrics.InterpretationThere is no clear evidence that allocating PHT resources to engaging in alcohol licensing is associated with downstream reductions in alcohol-related health harms or crimes, in the short term or over a seven year follow-up period. Such engagement likely has benefits in shaping the licensing system to take account of health issues longer term, but as current systems cannot reduce alcohol availability or contain online sales, their potential benefits are somewhat constrained.FundingThe ExILEnS project is funded by the NIHR Public Health Research Programme (project number 15/129/11). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Associations between public health team engagement in local alcohol licensing and public health and crime outcomes in England and Scotland: a timeseries analysis

BackgroundPublic health teams (PHTs) in England and Scotland engage to varying degrees with local alcohol licensing processes to try to reduce harm to individuals and communities. Evidence is scarce on whether this engagement is effective. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes. MethodsWe matched 20 higher activity PHTs and 19 lower activity PHTs, defined on the basis of initial discussions with local authorities, in England and Scotland using propensity score methods. We developed a semi-quantitative metric based on structured interviews, documentary analyses, and expert consultation to provide an estimate for the intensity of each PHT's engagement between April, 2012, and March, 2019. Public health outcomes were ambulance call outs, accident and emergency attendances, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality. Crime outcomes were violent and sexual crimes and public order offences. Data were analysed using negative binomial mixed-effects models, adjusted for area-level deprivation, age, season, country, time trend, population density, and local alcohol action area. Correlations were assessed between each outcome and PHT scores (range 0–35 points) and cumulative scores (range 0–364) for unlagged and 6-month lagged periods. FindingsThere was no evidence of associations between the primary exposure metric of 18-month average PHT engagement scores and public health or crime outcomes. However, lagged and unlagged cumulative PHT engagement was correlated with accident and emergency admissions for alcohol (–0·001 [95% CI –0·01 to –0·000] per unit exposure). Using the point estimates, had all areas had maximum PHT engagement across the whole period, 318 500 (unlagged) or 227 620 (lagged) accident and emergency admissions for alcohol (equivalent to 14–13%) might have been averted. InterpretationAn important limitation of this analysis is that it is not based on a randomised controlled trial, nor does it use an exposure change (ie a natural experiment), which restricts the strength of causal inferences. However, we report what, to our knowledge, is the first evidence of an association between PHT engagement in alcohol licensing and subsequent effects on public health in England and Scotland. Our findings provide evidence that PHT engagement in licensing might have a measurable positive effect, suggesting allocation of PHT resources to alcohol licensing could be beneficial. FundingNIHR Public Health Research Programme.

Demographics and clinical characteristics of alcohol-related admissions in a tertiary care hospital in Qatar: Does age matter?

Background: Alcohol consumption is a major cause of acute and chronic health conditions associated with comorbidities and traumatic injuries, despite its partial prohibition in some countries. Moreover, alcohol-related hospital admissions increase the burden on the healthcare system. More than 80% of the population in Qatar comprises expatriates. This study aimed to analyze the demographics and clinical characteristics of subjects with alcohol-related emergency department (ED) visits/hospitalization with respect to different age groups in a single tertiary hospital in Qatar.Methods: It is a retrospective observational study of adult patients who visited the ED at Hamad General Hospital between January 2013 and March 2015 and were screened positive for alcohol use. Collected data included sociodemographic characteristics, blood alcohol concentration (BAC), pattern of admission, previous medical history, laboratory investigations, treatment, hospital course, and mortality. Data were compared with respect to the distribution of age groups such as < 25, 25–34, 35–44, 45–54, and >55 years.Results: In total, 1506 consecutively admitted patients screened positive for alcohol use were included in the study; the majority of them were males (95.6%), non-Qatari nationals (71.1%), and aged 35–44 years (30.9%). The age groups 35–44 years and 45–54 years showed the highest median BAC ([0.24 interquartile range (IQR: 0.14–0.33)] and [0.24 (IQR: 0.13–0.33)], respectively) as compared to the other age groups (P = 0.001). The pattern of hospital admission, sociodemographic status, presence of comorbidities, laboratory investigations, and mortality showed specific age-related distribution. Particularly, young adults were more likely to have a previous ED visit due to trauma, whereas older patients’ previous hospital admissions were mostly related to various underlying comorbidities.Conclusion: This study highlighted the patterns of age and clinico-epidemiological status of patients with alcohol-attributable hospital admissions. Our study showed that alcohol consumption was higher among the working-age group. Further studies are needed to investigate changes in the alcohol consumption patterns that may help plan for allocation of health resources and prevention of alcohol-related problems.

Visualisation and optimisation of alcohol-related hospital admissions ICD-10 codes in Welsh e-cohort data.

IntroductionThe excessive consumption of alcohol is detrimental to long term health and increases the likelihood of hospital admission. However, definitions of alcohol-related hospital admission vary, giving rise to uncertainty in the effect of alcohol on alcohol-related health care utilization.ObjectivesTo compare diagnostic codes on hospital admission and discharge and to determine the ideal combination of codes necessary for an accurate determination of alcohol-related hospital admission.MethodsRoutine population-linked e-cohort data were extracted from the Secure Anonymised Information Linkage (SAIL) Databank containing all alcohol-related hospital admissions (n,= 92,553) from 2006 to 2011 in Wales, United Kingdom. The distributions of the diagnostic codes recorded at admission and discharge were compared. By calculating a misclassification rate (sensitivity-like measure) the appropriate number of coding fields to examine for alcohol-codes was established.ResultsThere was agreement between admission and discharge codes. When more than ten coding fields were used the misclassification rate was less than 1%.ConclusionWith the data at present and alcohol-related codes used, codes recorded at admission and discharge can be used equivalently to identify alcohol-related admissions. The appropriate number of coding fields to examine was established: fewer than ten is likely to lead to under-reporting of alcohol-related admissions. The methods developed here can be applied to other medical conditions that can be described using a certain set of diagnostic codes, each of which can be a known sole cause of the condition and recorded in multiple positions in e-cohort data.

Prevalence and patterns of hospital use for people with frequent alcohol-related hospital admissions, compared to non-alcohol and non-frequent admissions: a cohort study using routine administrative hospital data.

This study compared prevalence and hospital use among individuals frequently admitted to hospital in England with wholly attributable alcohol-related diagnoses (WAAD), known as alcohol-related frequent attenders (ARFAs), with those of non-alcohol frequent attenders (NAFAs), non-frequent alcohol attenders (ARNFAs) and non-alcohol non-frequent attenders (NANFAs). Cross-sectional and longitudinal analyses of 5years of England's Hospital Episode Statistics (HES). Hospital inpatients in England, UK, 2011-16. Two cohorts (2011/12=489 580/7 654 944 patients and 2015/16=490 384/7 660 108 patients) were selected from all adult patients aged ≥18years, treated in English hospitals between 1 April 2011 and 31 March 2016. Patients were categorized as having alcohol-related admissions if diagnoses included a WAAD (ICD-10 classification, WHO, 2016) and frequent admissions if they had more than three hospital admissions during a single HES year. Prevalence of ARFA, number of admissions (spells), occupied bed-days (OBDs), average length of stay (ALOS) and total admission costs over 5years were compared among ARFAs, ARNFAs, NAFAs and NANFAs. On average, 0.7% of people admitted to hospital per annum in England 2011-15 were ARFAs and more than a quarter of all frequent attenders (for all causes) to hospitals had a wholly attributable alcohol diagnosis on admission. ARFAs had longer ALOS than the other patient groups [5.55days versus ARNFA 4.7, NAFA 3.39 and NANFA 2.57days, F=1088.37 (3, 488 570, P<0.001)] in the 2015/16 index year; but fewer spells than NAFAs [5.38 ARFAs versus 5.98 NAFAs, F=20 536.25 (3, 490 380) P<0.001]. The ARFA cohort reduced in size (from 51 934 ARFAs to 20 548) in the course of 5years. ARFAs had the highest average total cost of admissions per person over 5years at £38 189. People with repeated admissions for alcohol-related problems in England appear to be a high-cost, high-need, complex group of patients that makes up more than a quarter of the country's alcohol admissions.

Access to specialist community alcohol treatment in England, and the relationship with alcohol-related hospital admissions: qualitative study of service users, service providers and service commissioners.

Since 2012 England has seen year-on-year reductions in people accessing specialist community alcohol treatment, and year-on-year increases in alcohol-related hospital admissions. We examined perceived barriers to accessing specialist treatment, and perceived reasons behind hospital admission increases. We conducted focus groups (n = 4) with service users and semi-structured interviews (n = 16) with service providers and service commissioners at four specialist community alcohol services in England, which experience either high or low rates of alcohol dependence prevalence and treatment access. Themes and subthemes were generated deductively drawing upon Rhodes' risk environment thesis. Data were organised using the framework approach. Data reveal a treatment sector profoundly affected at all levels by changes implemented in the Health and Social Care Act (HSCA) 2012. Substantial barriers to access exist, even in services with high access rates. Concerns regarding funding cuts and recommissioning processes are at the forefront of providers' and commissioners' minds. The lack of cohesion between community and hospital alcohol services, where hospital services exist, has potentially created an environment enabling the reduced numbers of people accessing specialist treatment. Our study reveals a treatment sector struggling with a multitude of problems; these pervade despite enaction of the HSCA, and are present at the national, service provider and individual service level. Although we acknowledge the problems are varied and multifaceted, their existence is echoed by the united voices of service users, service providers and service commissioners.

Demographic and socioeconomic patterns in the risk of alcohol-related hospital admission in children and young adults with childhood onset type-1 diabetes from a record-linked longitudinal population cohort study in Wales.

Little is known about alcohol-related harm in children and young adults with type 1 diabetes (T1D). Education on managing alcohol intake is provided to teenagers with T1D in paediatric clinics in Wales, but its effectiveness is unknown. We compared the patterns in risk of alcohol-related hospital admissions (ARHA) between individuals with and without childhood-onset T1D. We extracted data for 1 791 577 individuals born during 1979 to 2014 with a general practitioner registration in Wales, and record-linked the demographic data to ARHA between 1998 and June 2016 within the Secure Anonymised Information Linkage Databank (SAIL). Linkage to a national T1D register (Brecon Cohort) identified 3575 children diagnosed aged <15 years since 1995. We estimated hazard ratios (HRs) with 95% confidence intervals (95% CIs) for the risk of ARHA using recurrent-event models, including interaction terms. Individuals with T1D had a higher riskof ARHA (HR: 1.78; 95% CI: 1.60-1.98), adjusted for age group, sex, and deprivation. The risk in people with diabetes was highest aged 14 to 17 years, around three times higher than the peak in non-T1D aged 18 to 22. Females with diabetes had a lower risk generally. The association between deprivation and ARHA was weaker in the T1D group. Young people with T1D had increased risks of ARHA, particularly at school age, and smaller socioeconomic inequalities in ARHA. A review of interventions to reduce alcohol-related harm in T1D is needed, perhaps including modification of current education and guidance for teenagers on managing alcohol consumption and reviewing criteria for hospital admission.

The relationship between alcohol-related hospital admission and specialist alcohol treatment provision across local authorities in England since passage of the Health and Social Care Act 2012.

To our knowledge no previous studies have been conducted at the local authority level assessing relationships between alcohol-related hospital admission, specialist alcohol treatment provision and socioeconomic deprivation since the UK government passed the Health and Social Care Act in 2012. Our results, using publicly available national data-sets, suggest that the local authority areas in England most in need of adequately funded specialist alcohol treatment, because of high prevalence of alcohol dependence and deprivation, are not receiving targeted increased funding, and that the national rise in alcohol-related hospital admissions may be fuelled by local authority funding cuts to specialist alcohol treatment.

Short Term Impact of Minimum Pricing for Alcohol in Scotland

Advocates of minimum pricing predicted that it would have an almost immediate impact in Scotland, with modelling forecasting 58 fewer deaths and 1,299 fewer hospital admissions in the first year. In the eight months after minimum pricing was introduced, alcohol-related mortality fell at the same rate in Scotland as it did in England and Wales (7%). Alcohol-related hospital admissions rose slightly in Scotland in 2018/19 under minimum pricing. The median Scottish household (by income) spent an extra £100.88 on alcohol in the first year of minimum pricing while the median income group in England spent an extra £44.20, a difference of £56.68 per annum. Those on below-average incomes have been hit hardest, with those in the bottom income group increasing their expenditure on alcohol by eleven per cent.

Drinking beer, wine or spirits \u2013 does it matter for inequalities in alcohol-related hospital admission? A record-linked longitudinal study in Wales

BackgroundAlcohol-related harm has been found to be higher in disadvantaged groups, despite similar alcohol consumption to advantaged groups. This is known as the alcohol harm paradox. Beverage type is reportedly socioeconomically patterned but has not been included in longitudinal studies investigating record-linked alcohol consumption and harm. We aimed to investigate whether and to what extent consumption by beverage type, BMI, smoking and other factors explain inequalities in alcohol-related harm.Methods11,038 respondents to the Welsh Health Survey answered questions on their health and lifestyle. Responses were record-linked to wholly attributable alcohol-related hospital admissions (ARHA) eight years before the survey month and until the end of 2016 within the Secure Anonymised Information Linkage (SAIL) Databank. We used survival analysis, specifically multi-level and multi-failure Cox mixed effects models, to calculate the hazard ratios of ARHA. In adjusted models we included the number of units consumed by beverage type and other factors, censoring for death or moving out of Wales.ResultsPeople living in more deprived areas had a higher risk of admission (HR 1.75; 95% CI 1.23–2.48) compared to less deprived. Adjustment for the number of units by type of alcohol consumed only reduced the risk of ARHA for more deprived areas by 4% (HR 1.72; 95% CI 1.21–2.44), whilst adding smoking and BMI reduced these inequalities by 35.7% (HR 1.48; 95% CI 1.01–2.17). These social patterns were similar for individual-level social class, employment, housing tenure and highest qualification. Inequalities were further reduced by including either health status (16.6%) or mental health condition (5%). Unit increases of spirits drunk were positively associated with increasing risk of ARHA (HR 1.06; 95% CI 1.01–1.12), higher than for other drink types.ConclusionsAlthough consumption by beverage type was socioeconomically patterned, it did not help explain inequalities in alcohol-related harm. Smoking and BMI explained around a third of inequalities, but lower socioeconomic groups had a persistently higher risk of (multiple) ARHA. Comorbidities also explained a further proportion of inequalities and need further investigation, including the contribution of specific conditions. The increased harms from consumption of stronger alcoholic beverages may inform public health policy.

Increased and younger alcohol-related hospital admissions in young people with childhood-onset type-1 diabetes: a record-linked longitudinal population study in Wales

Increased and younger alcohol-related hospital admissions in young people with childhood-onset type-1 diabetes: a record-linked longitudinal population study in Wales

Hospital admissions and mortality in the 15 years after a first-time hospital contact with an alcohol problem: a prospective cohort study using the entire Danish population.

Potential benefits of preventing continued alcohol intake in individuals presenting at the hospital with an alcohol problem can be highlighted by studying their excess risk of subsequent morbidity and mortality. All Danish residents with a first-time hospital contact with alcohol problems (intoxication, harmful use or dependence) in 1998-2002 were followed through 2012 using healthcare registries. We compared their cause-specific rates of hospital admission and mortality to the expected rates derived from the general population by calculating standardized incidence rate ratios. The 26 716 men and 12 169 women who were hospitalized with alcohol problems (median age 44 years) had more than 10 times the rate of subsequent admission to psychiatric departments and three times the rate of subsequent admission to somatic departments compared with the general population. In particular, the hospital admission rates for gastroenterological disease and injuries were high. The cumulative all-cause 10-year mortality risk was 29% [95% confidence interval (CI), 28-30] in men and 26% (95% CI, 24-27) in women with alcohol problems. The ratios of observed to expected death rate for all-cause mortality were 4.0 (95%CI, 3.8-4.1) in men and 4.3 (95%CI, 4.0-4.7) in women and, for causes of death fully attributable to alcohol, 16 (95%CI, 15-17) in men and 33 (95%CI, 29-38) in women. Individuals hospitalized with alcohol problems have much higher rates of subsequent alcohol-related hospital admission and mortality than the general population. Increased focus on preventing continued alcohol consumption in these individuals may reduce their subsequent morbidity and mortality.

Epidemiology of alcohol-related emergency hospital admissions in children and adolescents: An e-cohort analysis in Wales in 2006-2011.

ObjectiveHarmful levels of alcohol consumption in young people are prevalent and of increasing public concern in the western world. Rates of alcohol-related emergency hospital admissions in children and young people between 10 to 17 years were described, and the reasons for these admissions and their association with socio-demographic factors were examined.MethodsE-cohort data were extracted from the Secure Anonymised Information Linkage Databank, which contained alcohol-related emergency hospital admissions (N = 2968) from 2006 to 2011 in children and adolescents aged 10 to 17 years in Wales. A generalised linear mixed model was fitted using a log-link with a population offset to the data to calculate incident rate ratios (IRRSs).ResultsThere was a general decreasing trend from 2006 to 2011 in the number and rate of alcohol-related emergency hospital admissions; the mean age of admission was 15.4 (standard deviation 1.4) years. In each of the four youngest age groups (10–13,14,15,16 years), females had higher IRRs than males. Males had slightly higher IRR compared to females only in the oldest age group (17 years). IRRs increased with increasing deprivation. The majority (92%) of the admissions lasted one day and most of the admissions (70%) occured during the last three days of the week with a peak on Saturday. The length of stay in hospital was longer in cases when self-harm were present. Multiple admissions showed high prevalance of serious self-harm cases in females. The number of admissions with injuries and falls were higher for males than females.ConclusionFemale children and adolescents were more likely to be admitted to hospital for alcohol-related reasons. These data illustrate the significant burden of alcohol-related harm in young people and highlight the need for interventions and policies that promote safe drinking practices among young people to prevent future alcohol-related harm during the life-course.