Dan V Blalock1,2, Janet Grubber1, Valerie A Smith1,3,4, Donna M Zulman5,6, Hollis J Weidenbacher1, Liberty Greene5,6, Eric A Dedert2,7, Matthew L Maciejewski1,3,4. 1. Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT, Durham Veterans Affairs Health Care System, Durham, NC, USA. 2. Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. 3. Department of Population Health Sciences, Duke University, Durham, NC, USA. 4. Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, USA. 5. Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA. 6. Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA. 7. Durham Veterans Affairs Medical Center, Durham, NC, USA.
Abstract
BACKGROUND: The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population. METHODS: We examined the association between alcohol use (measured by a screening instrument in primary care) and rates of all-cause and cardiovascular disease (CVD)-related 6-month hospitalization or death via electronic health records (EHRs) in a nationally representative sample of older, high-risk Veterans. Models were adjusted for sociodemographic and clinical characteristics, including frailty and comorbid conditions. RESULTS: The all-cause hospitalization or death rate at 6 months was 14.9%, and the CVD-related hospitalization or death rate was 1.8%. In adjusted analyses, all-cause hospitalization or death was higher in older Veterans who were nondrinkers or harmful use drinkers compared to moderate use drinkers, but CVD-related hospitalization or death was similar in all categories of drinking. CONCLUSIONS: These findings suggest that the complex association between alcohol and all-cause acute healthcare utilization found in the broader population is similar in older, high-risk Veteran patients. These findings do not support an association between alcohol consumption and CVD-specific hospitalizations. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
BACKGROUND: The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population. METHODS: We examined the association between alcohol use (measured by a screening instrument in primary care) and rates of all-cause and cardiovascular disease (CVD)-related 6-month hospitalization or death via electronic health records (EHRs) in a nationally representative sample of older, high-risk Veterans. Models were adjusted for sociodemographic and clinical characteristics, including frailty and comorbid conditions. RESULTS: The all-cause hospitalization or death rate at 6 months was 14.9%, and the CVD-related hospitalization or death rate was 1.8%. In adjusted analyses, all-cause hospitalization or death was higher in older Veterans who were nondrinkers or harmful use drinkers compared to moderate use drinkers, but CVD-related hospitalization or death was similar in all categories of drinking. CONCLUSIONS: These findings suggest that the complex association between alcohol and all-cause acute healthcare utilization found in the broader population is similar in older, high-risk Veteran patients. These findings do not support an association between alcohol consumption and CVD-specific hospitalizations. Published 2021. This article is a U.S. Government work and is in the public domain in the USA.
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