Abstract
Objectives: The aim of this study was to describe the principal reasons for admission, medical comorbidities, interventions and outcomes of patients admitted to New South Wales hospitals with alcohol-related cognitive impairment.
Methods: We extracted data from the NSW Admitted Patient Care Database for nearly 410 000 multi-day hospital admissions from 222 public hospitals ending between July 2006 and June 2007 for people aged 50 and over. Data linkage using a unique patient identifier, derived by the Centre for Health Record Linkage identified hospital transfers and readmissions for individual patients. Using ICD10-AM codes, we identified patients with alcohol-related dementia, amnesic syndrome due to alcohol, and Wernicke's encephalopathy, their principal reasons for admission and medical comorbidities, and procedures undertaken. Outcomes were length of stay, mortality, discharge destination, and readmission.
Results: A total of 462 patients diagnosed with alcohol-related dementia (n = 300; 82% male, mean age 63.9 years), Wernicke's encephalopathy (n = 77) or amnesic syndrome due to alcohol (n = 126) were identified with overlap between diagnoses. Alcohol-related dementia occurred in 1.4% of dementia patients, and was more likely to occur in younger age groups and men than other types of dementia. Alcohol-related mental disorder was recorded in 70% of alcohol-related dementia multi-day admissions: dependence (52%), ‘harmful use’ (11%) and withdrawal (12%). Principal reasons for admission for multi-day stays included alcohol-related mental disorder (18%), liver disease (11%) and injuries/poisonings (10%). Medical comorbidity was common. Like other dementia patients, alcohol-related dementia patients had longer length of stay (mean of 15 days) than non-dementia patients and more transfers to residential care (7%). However, mortality was similar to non-dementia patients (5%). Discharge at own risk was high (3.7%).
Conclusions: Alcohol-related dementia is a preventable and potentially reversible condition. Investigation of intervention strategies initiated during hospitalization are warranted.
Acknowledgements
The authors thank the New South Wales Department of Health for permission to use data from the Admitted Patient Data Collection and for provision of the data extract with patient identifiers derived by the Centre for Health Record Linkage (or CHeReL). We thank the other members of the Hospital Dementia Services project team, Gail Brien, Le Anh Pham Lobb and Charles Hudson, for their work on the project and assistance with this paper and the Australian Institute for Health and Welfare for hosting and supporting the project.
Declaration of interest: This study was funded by National Health & Medical Research Council dementia research grant no. 465701. The authors alone are responsible for the content and writing of the paper.