Research Article
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Factors Affecting the Length of Hospital Stay in Adult Patients With Alcohol Dependence

Year 2020, Volume 21, Issue 1, 24 - 33, 31.03.2020

Abstract

Objective: We aimed to investigate the causes of long hospital stay in adult patients with alcohol use disorder inpatient treatment. Method: This is a retrospective descriptive study. The data of the study included the records of patients treated in the alcohol and drug addiction clinic of Gazi University Hospital between 2005 and 2016. The records of 1543 patients with alcohol dependence were reached. Only the first hospitalization data of patients with recurrent admission were included in the analysis. As a result, the records of 906 patients were analyzed. ICD-10 classification was used as the diagnostic system. Results: The mean age of the study population was 51.95±11.54 years and 89.4% (n = 810) were male. Recurrent hospitalization was 26.7% (n = 242), medical comorbidity 5% (n = 45), and psychiatric comorbidity 28% (n = 254). In the logistic regression analysis evaluating the duration of hospitalization, the presence of bipolar affective disorder (BDD) increased the duration of hospitalization by 3.4 times (OR=3,457), and the presence of depression extended the duration of hospitalization by 1.8 times (OR=1,854). The length of hospital stay of those hospitalized between 2014-2016 was 12 times (OR=0,082) shorter than those hospitalized between 2005-2007. Conclusion: Some clinical variables (age, BDD and depression) have been shown to affect the duration of hospitalization in alcohol dependence. Together with these clinical variables, a non-clinical variable, such as the year of hospitalization, was found to affect the length of hospital stay 12-fold. Moreover, this effect can increase up to 34 times.

References

  • 1. Institute for Health Metrics and Evaluation (IHME). Findings from the Global Burden of Disease Study 2017. Seattle, WA: IHME, 2018.
  • 2. WHO. Global status report on alcohol and health 2018. Geneva: World Health Organization, 2018.
  • 3. TUBİM. Türkiye Uyuşturucu Raporu. Ankara: Emniyet Genel Müdürlüğü, 2019
  • 4. Laramée P, Kusel J, Leonard S, et al. The economic burden of alcohol dependence in europe. Alcohol Alcohol 2013; 48: 259-269.
  • 5. Fornaro M, Iasevoli F, Novello S, et al. Predictors of hospitalization length of stay among re-admitted treatment-resistant Bipolar Disorder inpatients. J Affect Disord 2018; 228: 118-124.
  • 6. Newman L, Harris V, Evans LJ, Beck A. Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK. Psychiatr Q 2018; 89: 33-43.
  • 7. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse: Results From the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511-2518.
  • 8. Ragazan DC, Eberhard J, Ösby U, Berge J. Gender influence on the bipolar disorder inpatient length of stay in Sweden, 2005–2014: A register-based study. J Affect Disord 2019; 256: 183-191.
  • 9. Gerding LB, Labbate LA, Measom MO, et al. Alcohol dependence and hospitalization in schizophrenia. Schizophr Res 1999; 38: 71-75.
  • 10. Özpoyraz N, Tamam L, Karakuş G. Alkol Bağımlılığı Ve Duygudurum Bozuklukları. J Depend 2008; 9: 31–35.
  • 11. Schatzberg AF, Weiss RD, Brady KT, Culpepper L. Bridging the clinical gap: managing patients with co-occurring mood, anxiety, and alcohol use disorders. Introduction. CNS Spectr 2008;
  • 12. Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007; 13: 3.
  • 13. Türkçapar M, Akdemir A, Elverici Ş, et al. Yatarak tedavi gören bir grup alkol bağımlısında ek psikiyatrik hastalıklar, kişilik bozuklukları, depresyon ve kaygı düzeyleri. Psikiyatr Psikol Psikofarmakol Derg 1997; 5: 29–34.
  • 14. Johnson BA. Role of the serotonergic system in the neurobiology of alcoholism: Implications for treatment. CNS Drugs 2004; 18: 1105-1118.
  • 15. Keskin G, Gumus AB. Investigation of depressive symptoms and related variables with depressive symptoms in alcohol and substance abusers. Dusunen Adam 2017; 30: 124-135.
  • 16. Bilban M, Škibin L. Presence of alcohol in suicide victims. Forensic Sci Int 2005; 147: 9-12.
  • 17. Mohapatra S, Patra J, Popova S, et al. Social cost of heavy drinking and alcohol dependence in high-income countries. Int J Public Health 2010; 55: 149-157.
  • 18. Lereboullet J. [The occurrence of alcoholism in hospitals: its cost]. Bull Acad Natl Med 1968; 152: 223–34.
  • 19. Gottheil E, McLellan AT, Druley KA. Length of stay, patient severity and treatment outcome: Sample data from the field of alcoholism. J Stud Alcohol 1992; 53: 69-75.
  • 20. Ding K, Yang J, Cheng G, et al. Hospitalizations and hospital charges for co-occurring substance use and mental disorders. J Subst Abuse Treat 2011; 40: 366-375.
  • 21. Osby U, Tiainen A, Backlund L, et al. Psychiatric admissions and hospitalization costs in bipolar disorder in Sweden. J Affect Disord 2009; 115: 315-322.
  • 22. Wickizer TM, Lessler D. Do Treatment Restrictions Imposed by Utilization Management Increase the Likelihood of Readmission for Psychiatric Patients?. Med Care 1998; 36: 844-850.

Alkol Bağımlılığı Olan Erişkin Hastalarda Hastanede Kalış Süresini Etkileyen Faktörler

Year 2020, Volume 21, Issue 1, 24 - 33, 31.03.2020

Abstract

Amaç: Alkol kullanım bozukluğu olan yatarak tedavi gören erişkin hastalarda uzun süre hastanede kalış nedenlerini araştırmayı amaçladık. Yöntem: Bu retrospektif tanımlayıcı bir çalışmadır. Araştırmanın verileri, 2005-2016 yılları arasında Gazi Üniversitesi Hastanesi alkol ve uyuşturucu bağımlılığı kliniğinde tedavi edilen hastaların kayıtlarını içermektedir. Alkol bağımlılığı olan 1543 hastanın kayıtlarına ulaşılmıştır. Tekrarlayan başvuruları olan hastaların sadece ilk yatış verileri analize dahil edildi. Sonuç olarak 906 hastanın kayıtları analiz edildi. Tanı sistemi olarak ICD-10 sınıflaması kullanıldı. Bulgular: Çalışma popülasyonunun ortalama yaşı 51.95 ± 11.54 yıl idi ve% 89.4'ü (n = 810) erkekti. Tekrarlayan hastaneye yatış% 26.7 (n = 242), tıbbi eştanı% 5 (n = 45) ve psikiyatrik eştanı% 28 (n = 254) idi. Hastanede yatış süresini değerlendiren lojistik regresyon analizinde bipolar affektif bozukluğun (BDD) varlığı hastanede yatış süresini 3,4 kat (OR=3,457) arttırırken, depresyonun varlığı hastanede yatış süresini 1,8 kat (OR=1,854) artırdı. 2014-2016 yılları arasında hastaneye yatırılanların hastanede kalış süresi 2005-2007 yılları arasında hastaneye yatırılanlardan 12 kat (OR=0,082) daha kısaydı. Sonuç: Bazı klinik değişkenlerin (yaş, BDD ve depresyon) alkol bağımlılığında yatış süresini etkilediği gösterilmiştir. Bu klinik değişkenlerle birlikte, hastaneye yatış yılı gibi klinik olmayan bir değişkenin hastanede kalış süresini 12 kat etkilediği bulunmuştur. Ayrıca, bu etki 34 kata kadar artabilir.

References

  • 1. Institute for Health Metrics and Evaluation (IHME). Findings from the Global Burden of Disease Study 2017. Seattle, WA: IHME, 2018.
  • 2. WHO. Global status report on alcohol and health 2018. Geneva: World Health Organization, 2018.
  • 3. TUBİM. Türkiye Uyuşturucu Raporu. Ankara: Emniyet Genel Müdürlüğü, 2019
  • 4. Laramée P, Kusel J, Leonard S, et al. The economic burden of alcohol dependence in europe. Alcohol Alcohol 2013; 48: 259-269.
  • 5. Fornaro M, Iasevoli F, Novello S, et al. Predictors of hospitalization length of stay among re-admitted treatment-resistant Bipolar Disorder inpatients. J Affect Disord 2018; 228: 118-124.
  • 6. Newman L, Harris V, Evans LJ, Beck A. Factors Associated with Length of Stay in Psychiatric Inpatient Services in London, UK. Psychiatr Q 2018; 89: 33-43.
  • 7. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of Mental Disorders With Alcohol and Other Drug Abuse: Results From the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511-2518.
  • 8. Ragazan DC, Eberhard J, Ösby U, Berge J. Gender influence on the bipolar disorder inpatient length of stay in Sweden, 2005–2014: A register-based study. J Affect Disord 2019; 256: 183-191.
  • 9. Gerding LB, Labbate LA, Measom MO, et al. Alcohol dependence and hospitalization in schizophrenia. Schizophr Res 1999; 38: 71-75.
  • 10. Özpoyraz N, Tamam L, Karakuş G. Alkol Bağımlılığı Ve Duygudurum Bozuklukları. J Depend 2008; 9: 31–35.
  • 11. Schatzberg AF, Weiss RD, Brady KT, Culpepper L. Bridging the clinical gap: managing patients with co-occurring mood, anxiety, and alcohol use disorders. Introduction. CNS Spectr 2008;
  • 12. Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2007; 13: 3.
  • 13. Türkçapar M, Akdemir A, Elverici Ş, et al. Yatarak tedavi gören bir grup alkol bağımlısında ek psikiyatrik hastalıklar, kişilik bozuklukları, depresyon ve kaygı düzeyleri. Psikiyatr Psikol Psikofarmakol Derg 1997; 5: 29–34.
  • 14. Johnson BA. Role of the serotonergic system in the neurobiology of alcoholism: Implications for treatment. CNS Drugs 2004; 18: 1105-1118.
  • 15. Keskin G, Gumus AB. Investigation of depressive symptoms and related variables with depressive symptoms in alcohol and substance abusers. Dusunen Adam 2017; 30: 124-135.
  • 16. Bilban M, Škibin L. Presence of alcohol in suicide victims. Forensic Sci Int 2005; 147: 9-12.
  • 17. Mohapatra S, Patra J, Popova S, et al. Social cost of heavy drinking and alcohol dependence in high-income countries. Int J Public Health 2010; 55: 149-157.
  • 18. Lereboullet J. [The occurrence of alcoholism in hospitals: its cost]. Bull Acad Natl Med 1968; 152: 223–34.
  • 19. Gottheil E, McLellan AT, Druley KA. Length of stay, patient severity and treatment outcome: Sample data from the field of alcoholism. J Stud Alcohol 1992; 53: 69-75.
  • 20. Ding K, Yang J, Cheng G, et al. Hospitalizations and hospital charges for co-occurring substance use and mental disorders. J Subst Abuse Treat 2011; 40: 366-375.
  • 21. Osby U, Tiainen A, Backlund L, et al. Psychiatric admissions and hospitalization costs in bipolar disorder in Sweden. J Affect Disord 2009; 115: 315-322.
  • 22. Wickizer TM, Lessler D. Do Treatment Restrictions Imposed by Utilization Management Increase the Likelihood of Readmission for Psychiatric Patients?. Med Care 1998; 36: 844-850.

Details

Primary Language Turkish
Subjects Psychiatry
Journal Section Research
Authors

Bahadır GENİŞ> (Primary Author)
ZONGULDAK ÇAYCUMA DEVLET HASTANESİ
0000-0001-8541-7670
Türkiye


Behçet COŞAR>
GAZİ ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0002-6422-499X
Türkiye


Zehra ARIKAN>
GAZİ ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-3138-2315
Türkiye

Publication Date March 31, 2020
Acceptance Date January 23, 2020
Published in Issue Year 2020, Volume 21, Issue 1

Cite

AMA Geniş B. , Coşar B. , Arıkan Z. Alkol Bağımlılığı Olan Erişkin Hastalarda Hastanede Kalış Süresini Etkileyen Faktörler. Bağımlılık Dergisi. 2020; 21(1): 24-33.