title: Hospital Stay and Engagement in Outpatient Follow-Up After Alcohol Emergency Detox: A 1-Year Comparison Study.
abstract: BACKGROUND
  Inpatient alcohol detoxifications are only proposed after motivational outpatient encounters because detoxification directly from the emergency department (ED) is believed to be associated with early dropout and poor adherence to outpatient follow-up. The aim of this prospective follow-up study was to test the feasibility of unscheduled (UP) alcohol detoxification directly from the ED and to compare the 1-year follow-up of these patients to that of scheduled (SP) patients.
  
  
  METHODS
  A quasi-naturalistic prospective follow-up study of 120 patients: 60 consecutively admitted patients referred directly by the ED for alcohol detoxification (UP) were compared to 60 consecutively admitted patients who had undergone the usual preparation for an inpatient detoxification program (SP). The length of hospitalization (in days) and attendance to postdischarge outpatient visits during the first year was compared.
  
  
  RESULTS
  UP patients were older, less frequently employed, and had more somatic comorbidities compared with SP patients. The UP length of stay was significantly longer (20 ± 16 vs. 14 ± 6, p = 0.04). No difference in their postdischarge attendance was observed; the number of patients attending 1 session (57% UP vs. 65% SP, p = 0.227) and 5 sessions (22% UP vs. 32% SP, p = 0.151) and the mean number of postdischarge visits attended were comparable between the UP and SP groups (2.7 ± 6 vs. 4.5 ± 6; Mann-Whitney U = 1,517, p = 0.124).
  
  
  CONCLUSIONS
  We did not find that UP patients who had been admitted for alcohol detoxification had a significantly higher dropout rate or lower postdischarge addiction treatment attendance. Because they may have several advantages, detoxification programs directly linked with EDs should be further evaluated.
authors: Service de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.
authors: Julien
authors: J
authors: Azuar
authors: Service de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, Paris, France.
authors: Frank
authors: F
authors: Questel
authors: Service de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, Paris, France.
authors: Eric
authors: E
authors: Hispard
authors: Department of Academic Psychiatry, Institute of Neuroscience, Newcastle University, United Kingdom.
authors: Jan
authors: J
authors: Scott
authors: Service de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|INSERM U1144, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France.
authors: Florence
authors: F
authors: Vorspan
authors: Service de Médecine Addictologique, Hôpital Fernand Widal, AP-HP, Paris, France.|Faculté de Médecine, Université Paris Diderot, Paris, France.|INSERM U1144, Université Paris Descartes, Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France.
authors: Frank
authors: F
authors: Bellivier
mesh_terms: D000437:Alcoholism / Q000628:therapy*; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies
keywords: Alcohol; Detoxification; Emergency; Engagement; Inpatients