Alcohol use disorder and healthcare utilization in patients with chronic asthma and obstructive lung disease.
Alcohol use disorder and healthcare utilization in patients with chronic asthma and obstructive lung disease.
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DOI：
10.1016/j.alcohol.2021.03.002
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Zein JG
中科院分区：
文献类型：
--
作者：
MacMurdo M;Lopez R;Udeh BL;Zein JG
酒精使用障碍(AUD)与严重的直接发病率和死亡率有关。酒精对慢性哮喘和阻塞性肺病的影响尚不清楚。AUD治疗可能代表着一个潜在的目标，以改善这一患者群体的医疗利用率和医疗成本。利用2012-2015年全国再入院数据库(NRD)和国家急诊科样本(NeDS)的数据，确定了被诊断为哮喘或COPD的患者。评估记录的药物滥用、住院率、再次住院的频率、住院严重程度和费用的标志物。在NeDS队列中，确认了2,048,380名被诊断为COPD或哮喘的患者。记录在案的AUD患者更有可能出现呼吸衰竭(OR1.32(1.26，1.39)p<；0.001)，并且更有可能需要在急诊室进行机械通气。(或1.3[1.19，1.42]，p<；0.001)。在NRD队列中，确定了1,096,663人入院。AUD发生率为4.1%。AUD与更长的住院时间(OR1.06(1.04，1.08)P<；0.001)、更高的住院费用和30天再住院的可能性(OR1.24(1.2，1.28)P<；0.001)相关。在哮喘或COPD患者中，AUD与疾病发病率和医疗保健利用率的增加有关。在对物质滥用和相关的共病进行调整后，这种影响仍然存在。在这一患者群体中识别和治疗AUD可能会改善疾病、患者和卫生系统的结局。
Alcohol use disorder (AUD) is associated with significant direct morbidity and mortality. The impact of alcohol on chronic asthma and obstructive lung disease is unknown. AUD treatment may represent a potential target to improve healthcare utilization and healthcare costs in this patient population. Utilizing data from the 2012–2015 National Readmissions Database (NRD), and National Emergency Department Sample (NEDS) patients with a diagnosis of asthma or COPD were identified. Documented substance misuse, rates of hospitalization, frequency of hospital readmission, markers of admission severity and cost were assessed. Within the NEDS cohort, 2,048,380 patients with a diagnosis of COPD or asthma were identified. Patients with documented AUD were more likely to present with respiratory failure (OR 1.32 (1.26, 1.39) p < 0.001) and more likely to require mechanical ventilation in the emergency room. (OR 1.30 [1.19, 1.42], p<0.001). Within the NRD cohort 1,096,663 hospital admissions were identified. AUD was documented in 4.1%. AUD was associated with an increased length of stay (OR 1.06 (1.04, 1.08) p <0.001), increased hospitalization cost and an increased likelihood of 30 day readmission (OR 1.24 (1.2, 1.28) p <0.001). AUD is associated with increased disease morbidity and healthcare utilization in patients with asthma or COPD. This impact persists after adjusting for substance misuse, and associated comorbidities. Identifying and treating AUD in this patient population may improve disease, patient and health-system outcomes.
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