title: Postdetoxification Factors Predicting Alcohol-Related Emergency Room Visits 12 to 24 Months After Discharge: Results from a Prospective Study of Patients with Alcohol Dependence.
abstract: BACKGROUND
  Relapse is common in patients with alcohol dependence, even after detoxification. The aims of this prospective study were to investigate changes affecting patients during the first 6 months after discharge from hospitalization for detoxification and to determine the influence of these changes on the likelihood of alcohol-related emergency room (ER) visits in the following 18-month period.
  
  
  METHODS
  The study included 88 patients hospitalized for participation in a detoxification program in the addiction department of a university hospital in Rennes, France. Alcohol consumption, psychiatric symptoms, and life events were investigated by addiction specialists during hospitalization and 6 months afterward. For each patient, the number of alcohol-related ER visits in the last 6 months was prospectively recorded at the hospital 12, 18, and 24 months after hospitalization. The rate ratios of ER visits as a function of sociodemographic variables and changes observed 6 months after discharge were estimated using Poisson regression with autoregressive errors.
  
  
  RESULTS
  Nearly half of the patients (47.7%) had ER visits in the 12- to 24-month period following discharge. The likelihood of ER visits was higher for patients living with friends/parents and for those with aggravated psychiatric symptoms, negative changes in their family life, and who had a medical follow-up in the 6 months after discharge. In contrast, the likelihood of ER visits was lower for patients living with children and those with improved psychiatric morbidity. Alcohol consumption and psychiatric symptoms at baseline had no significant effect.
  
  
  CONCLUSIONS
  Monitoring changes in psychiatric symptoms and family life early after a detoxification program may help identify patients who are vulnerable to relapse in the subsequent 18-month period. Systematic screening for these changes as early as possible, in combination with appropriate treatment and the establishment of a social support system, could be fundamental in avoiding further relapses and ER visits.
authors.affiliation: EHESP School of Public Health, Rennes, France.
authors.forename: Aymery
authors.initials: A
authors.lastname: Constant
authors.affiliation: CHU de Rennes, Unité d'Addictologie, Rennes, France.|Faculté de Médecine, Univ Rennes 1, Rennes, France.
authors.forename: Antonia
authors.initials: A
authors.lastname: Le Gruyer
authors.affiliation: CHU de Rennes, Unité d'Addictologie, Rennes, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Le Lan
authors.affiliation: Faculté de Médecine, Univ Rennes 1, Rennes, France.|Department of Public Health, Rennes University Hospital, Rennes, France.
authors.forename: Francoise
authors.initials: F
authors.lastname: Riou
authors.affiliation: CHU de Rennes, Unité d'Addictologie, Rennes, France.|Faculté de Médecine, Univ Rennes 1, Rennes, France.|INSERM UMR 991, Rennes, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Moirand
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012931:Social Environment
keywords: Alcohol Dependence; Determinant Analysis; Detoxification; Emergency Room Visits; Prospective Study