Point prevalence of alcoholism in hospitalized patients: continuing challenges of detection, assessment, and diagnosis.
OBJECTIVE
To measure a 1-day point prevalence of alcohol dependence among hospitalized patients and to assess practices of detection, evaluation, and diagnosis of alcohol problems.


METHODS
On April 27, 1994, a total of 795 adult inpatients at 2 midwestern teaching hospitals were asked to complete a survey that included the Self-administered Alcoholism Screening Test (SAAST). The records of SAAST-positive patients were reviewed to determine the numbers of patients receiving laboratory screening for alcoholism, addiction consultative services, and a discharge diagnosis of alcoholism.


RESULTS
The survey response rate was 84% (667/795). Of the 569 patients who provided SAAST information, 42 (7.4%) had a positive SAAST score and thus were identified as alcohol dependent. Thirteen (31%) of the 42 alcoholic patients received addiction or psychiatric consultative services during their hospitalization. Serum gamma-glutamyltransferase was measured in 4 (11%) of the 38 actively drinking alcoholic patients. Three (7%) of 42 alcoholic patients received a discharge diagnosis of alcohol abuse or dependence.


CONCLUSIONS
The alcoholism prevalence rate was lower than those observed in several other US hospitals. Laboratory testing may be underutilized in identifying hospitalized patients who may be addicted to alcohol. Physician use of consultative services and diagnosis of alcohol dependence had not improved from similar observations more than 20 years earlier. These findings may indicate persistent problems in physician detection, assessment, and diagnosis of alcoholism.
Schneekloth
T D
TD
Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. schneekloth.terry@mayo.edu
Morse
R M
RM
Herrick
L M
LM
Suman
V J
VJ
Offord
K P
KP
Davis
L J
LJ
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D015995:Prevalence; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase