title: Alcohol use disorders among surgical patients: unplanned 30-days readmissions, length of hospital stay, excessive costs and mortality.
abstract: OBJECTIVE
  Alcohol use disorders (AUD) have been associated with an increased risk of unplanned hospital readmissions (URA). We analyzed in a sample of 87 Spanish Hospitals if surgical patients with AUD had a higher risk of URA and if among patients with URA, those with AUD had an excess length of hospital stay, higher hospital expenses and increased risk of mortality.
  
  
  METHODS
  We analyzed data of patients who underwent surgical operations during the period between 2008 and 2010. URA was defined as unplanned readmissions during the first 30 days after hospital departure. The primary outcome was risk of URA in patients with AUD. Secondary outcomes were mortality, excess length of stay and over expenditure.
  
  
  RESULTS
  A total of 2,076,958 patients who underwent surgical operations were identified: 68,135 (3.3%) had AUD, and 62,045 (3.0%) had at least one URA. Among patients with AUD 4212 (6.2%) had at least one URA and among patients without AUD 57,833 (2.9%) had at least one URA. Multivariable analysis demonstrated that AUD was an independent predictor of developing URA (Odds ratio: 1.56; 95% CI: 1.50-1.62). Among surgical patients with URA, those with AUD had longer lengths of hospital stay (2.9 days longer), higher hospital costs (2885.8 Euros or 3858.3 US Dollars), higher risk of death (OR: 2.16, 95% CI: 1.92-2.44) and higher attributable mortality (11.2%).
  
  
  CONCLUSIONS
  Among surgical patients, AUD increase the risk of URA, and among patients with URA, AUD heighten the risk of in-hospital death, and cause longer hospital stays and over expenditures.
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain. Electronic address: mgili@us.es.
authors: Miguel
authors: M
authors: Gili-Miner
authors: Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain.
authors: Luis
authors: L
authors: Béjar-Prado
authors: Unidad de Gestión Clínica de Anestesiología y Bloque Quirúrgico, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain.
authors: Enrique
authors: E
authors: Gili-Ortiz
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain.
authors: Gloria
authors: G
authors: Ramírez-Ramírez
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Av. Sánchez Pizjuán s/n, 41007 Seville, Spain.
authors: Julio
authors: J
authors: López-Méndez
authors: Unidad de Gestión Clínica de Anestesiología y Bloque Quirúrgico, Hospital Universitario Virgen Macarena, Av. Dr. Fedriani s/n, 41070 Seville, Spain.
authors: José-Manuel
authors: JM
authors: López-Millán
authors: Unidad de Gestión Clínica de Diagnóstico por la Imagen, Hospital Universitario Virgen de Rocío, Av. Manuel Siurot s/n, 41013 Seville, Spain.
authors: Brett
authors: B
authors: Sharp
mesh_terms: D019973:Alcohol-Related Disorders / Q000191:economics* / Q000401:mortality / Q000628:therapy; D015331:Cohort Studies; D016208:Databases, Factual / Q000639:trends; D005260:Female; D017721:Hospital Costs / Q000639:trends*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000191:economics / Q000639:trends*; D011183:Postoperative Complications / Q000191:economics* / Q000401:mortality
keywords: Alcohol use disorders; Excessive costs; Mortality; Prolonged hospital stay; Unplanned hospital readmissions