Study reveals failure in identification of women at risk from alcohol abuse

Es ist allgemein bekannt, daß eine frühe Diagnose im Suchtbereich zu einem besseren therapeutischen Resultat führt und körperliche sowie psychosoziale Folgeschäden, aber auch massive Folgekosten verhindert. Deshalb wurden im Bereich Alkoholscreening in den letzten 15 Jahren weltweit aufwendige Forschungsarbeiten durchgeführt mit allerdings ernüchternden Resultaten. Abgesehen vom noch relativ neuen und teuren CDT-Test (Carbohydrate-deficient Transferrin) und einigen Abänderungen von Fragebögen (vorwiegend Kürzungen) stehen uns momentan als Screeningtests weiterhin nur die seit Jahrzehnten verwendeten und etablierten Methoden zur Verfügung. Das persönliche Gespräch, eine spezifische Anamnese und die Erfahrung des einzelnen Therapeuten wird deshalb auch in Zukunft nicht so rasch ersetzt werden können. Dabei gilt es aber auch in der Zukunft, eigene Ängste vor der Diagnose Alkoholismus und deren allfälligen Folgen sowohl für den Patienten wie auch den Praxisbetrieb zu überwinden. Die Plinius Major Society empfiehlt in ihren «Guidelines on evaluation of treatment of alcohol dependence» als Kurztest (allgemeines Screening) den CAGE-Fragebogen abzugeben, der vom Patienten in kurzer Zeit selbständig durchgeführt werden kann. In der Hausarztpraxis oder der Klinik besser bewährt und aufschlußreicher sind der MALT oder AUDIT, da diese schnell durchführbar und aussagekräftiger sind. Als gängigste und immer noch als die am weitesten verbreiteten Labormarker empfiehlt sie die Durchführung von gamma-GT, MCV, GOT/GPT und CDT

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Is the National Institute on Alcohol Abuse and Alcoholism Screening Guide Useful for Identifying Adolescents at Risk for Later Cigarette Smoking? A Prospective Study in Primary Care Clinics

Journal of Addiction Medicine ◽

10.1097/adm.0000000000000459 ◽

2019 ◽

Vol 13 (2) ◽

pp. 119-122 ◽

Cited By ~ 1

Author(s):

William G. Shadel ◽

Rachana Seelam ◽

Layla Parast ◽

Lisa S. Meredith ◽

Elizabeth J. D’Amico

Keyword(s):

Primary Care ◽

At Risk ◽

Alcohol Abuse ◽

Cigarette Smoking ◽

Prospective Study ◽

Primary Care Clinics ◽

A Prospective Study

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Performance of the Pictorial Representation of Illness and Self Measure in Individuals with Alcohol Dependence, Alcohol Abuse or At-Risk Drinking

Psychotherapy and Psychosomatics ◽

10.1159/000092896 ◽

2006 ◽

Vol 75 (4) ◽

pp. 249-256 ◽

Cited By ~ 9

Author(s):

Susa Reinhardt ◽

Gallus Bischof ◽

Janina Grothues ◽

Ulrich John ◽

Hans-Jürgen Rumpf

Keyword(s):

At Risk ◽

Alcohol Abuse ◽

Alcohol Dependence ◽

Pictorial Representation

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COVID-19-Related Neuropsychiatric Symptoms in Patients With Alcohol Abuse Conditions During the SARS-CoV-2 Pandemic: A Retrospective Cohort Study Using Real World Data From Electronic Health Records of a Tertiary Hospital

Frontiers in Neurology ◽

10.3389/fneur.2021.630566 ◽

2021 ◽

Vol 12 ◽

Author(s):

Carolina Varela Rodríguez ◽

Francisco Arias Horcajadas ◽

Cristina Martín-Arriscado Arroba ◽

Carolina Combarro Ripoll ◽

Alba Juanes Gonzalez ◽

...

Keyword(s):

At Risk ◽

Cohort Study ◽

Alcohol Abuse ◽

Retrospective Cohort ◽

Neuropsychiatric Symptoms ◽

Personal History ◽

Real World Data ◽

Health Records ◽

History Of ◽

Electronic Health

Patients with an alcohol abuse disorder exhibit several medical characteristics and social determinants, which suggest a greater vulnerability to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a worse course of the coronavirus disease 2019 (COVID-19) once infected. During the first wave of the COVID-19, most of the countries have register an increase in alcohol consumption. However, studies on the impact of alcohol addiction on the risk of COVID-19 infection are very scarce and inconclusive. This research offers a descriptive observational retrospective cohort study using real world data obtained from the Electronic Health Records. We found that patients with a personal history of alcohol abuse were 8% more likely to extend their hospitalization length of stay for 1 day (95% CI = 1.04–1.12) and 15% more likely to extend their Intensive Care Unit (ICU) length of stay (95% CI = 1.01–1.30). They were also 5.47 times more at risk of needing an ICU admission (95% CI = 1.61–18.57) and 3.54 times (95% CI = 1.51–8.30) more at risk of needing a respirator. Regarding COVID-19 symptoms, patients with a personal history of alcohol abuse were 91% more likely of exhibiting dyspnea (95% CI = 1.03–3.55) and 3.15 times more at risk of showing at least one neuropsychiatric symptom (95% CI = 1.61–6.17). In addition, they showed statistically significant differences in the number of neuropsychiatric symptoms developed during the COVID-19 infection. Therefore, we strongly recommend to warn of the negative consequences of alcohol abuse over COVID-19 complications. For this purpose. Clinicians should systematically assess history of alcohol issues and drinking habits in all patients, especially for those who seek medical advice regarding COVID-19 infection, in order to predict its severity of symptoms and potential complications. Moreover, this information should be included, in a structured field, into the Electronic Health Record to facilitate the automatic extraction of data, in real time, useful to evaluate the decision-making process in a dynamic context.

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Study: One in five men at risk of alcohol abuse

PsycEXTRA Dataset ◽

10.1037/e515362009-004 ◽

2009 ◽

Keyword(s):

At Risk ◽

Alcohol Abuse

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The influence of alcohol abuse on agitation, delirium and sedative requirements of patients admitted to a general intensive care unit

Journal of the Intensive Care Society ◽

10.1177/1751143718787748 ◽

2018 ◽

Vol 20 (3) ◽

pp. 208-215

Author(s):

Donald Stewart ◽

John Kinsella ◽

Joanne McPeake ◽

Tara Quasim ◽

Alex Puxty

Keyword(s):

Intensive Care Unit ◽

At Risk ◽

Intensive Care ◽

Alcohol Abuse ◽

Low Risk ◽

World Health ◽

Related Disease ◽

Risk Patients ◽

The Impact ◽

Alcohol Dependent

Purpose Patients with alcohol-related disease constitute an increasing proportion of those admitted to intensive care unit. There is currently limited evidence regarding the impact of alcohol use on levels of agitation, delirium and sedative requirements in intensive care unit. This study aimed to determine whether intensive care unit-admitted alcohol-abuse patients have different sedative requirements, agitation and delirium levels compared to patients with no alcohol issues. Methods This retrospective analysis of a prospectively acquired database (June 2012–May 2013) included 257 patients. Subjects were stratified into three risk categories: alcohol dependency (n = 69), at risk (n = 60) and low risk (n = 128) according to Fast Alcohol Screening Test scores and World Health Organisation criteria for alcohol-related disease. Data on agitation and delirium were collected using validated retrospective chart-screening methods and sedation data were extracted and then log-transformed to fit the regression model. Results Incidence of agitation (p = 0.034) and delirium (p = 0.041) was significantly higher amongst alcohol-dependent patients compared to low-risk patients as was likelihood of adverse events (p = 0.007). In contrast, at-risk patients were at no higher risk of these outcomes compared to the low-risk group. Alcohol-dependent patients experienced suboptimal sedation levels more frequently and received a wider range of sedatives (p = 0.019) but did not receive higher daily doses of any sedatives. Conclusions Our analysis demonstrates that when admitted to intensive care unit, it is those who abuse alcohol most severely, alcohol-dependent patients, rather than at-risk drinkers who have a significantly increased risk of agitation, delirium and suboptimal sedation. These patients may require closer assessment and monitoring for these outcomes whilst admitted.

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