Mortality outcomes in alcohol related cognitive impairment in an acute hospital setting.

IF 2.2 4区医学 Q3 SUBSTANCE ABUSE

Alcohol and alcoholism Pub Date : 2025-05-14 DOI:10.1093/alcalc/agaf033

Helen White, Lynn Owens, Edward Britton, David Byrne, Omar Elshaarawy, Ian Gilmore, Andrea Jorgensen, Cecil Kullu, Munir Pirmohamed, Christopher Probert, Gillian O'Hare, Paul Richardson

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引用次数: 0

Abstract

Aims: Alcohol related cognitive impairment (ARCI) impacts an individual's ability to engage in treatment thus may result in poorer outcomes. We aimed to describe outcomes in a legacy cohort of patients with ARCI, identified in an acute hospital setting.

Method: We conducted a retrospective review of a cohort of patients who underwent screening for ARCI between 1 April 2017 and 31 March 2018. Those identified with alternative causes of cognitive impairment were excluded. The Montreal Cognitive Assessment Tool (MoCA©) was utilized to determine presence, and severity, of cognitive impairment. These patients were referred to a multi-disciplinary meeting (MDT) and an out-patient clinic. Mortality was recorded at 3 years. Cox-regression analysis was undertaken and, Kaplan Meier (KM) plots were prepared to visualize the data.

Results: A total of 210 patients met criteria for ARCI screening. Multi-variate analysis found an association between ARCI and mortality at 3 years, Hazard Ratio (HR) 1.732 (p = .019). Co-existent Chronic Liver disease (CLD) increased this association, HR 1.722 (p = .020) but CLD in isolation did not increase mortality risk, HR 1.223 (p = .401). Severe ARCI had the strongest mortality association (p = <.001). Subsequent engagement with the ARCI care pathway improved outcomes, HR .324; (p = .008).

Conclusion: ARCI, identified by a simple, bed-side test is significantly associated with early mortality. This relationship is more marked in the presence of liver disease. The more severe the ARCI, the stronger relationship with death by 3 years. The cohort mean age was 52, a decade younger than the expected age at diagnosis of cognitive impairment in the general population.

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急性医院环境中酒精相关认知障碍的死亡率结局

目的：酒精相关认知障碍（ARCI）影响个体参与治疗的能力，因此可能导致较差的结果。我们的目的是描述在急性医院环境中确定的ARCI患者的遗留队列的结果。方法：我们对2017年4月1日至2018年3月31日期间接受ARCI筛查的患者队列进行了回顾性研究。那些被确定为其他认知障碍原因的患者被排除在外。使用蒙特利尔认知评估工具（MoCA©）来确定认知障碍的存在及其严重程度。这些患者被转介到多学科会议（MDT）和门诊诊所。3岁时记录死亡率。进行cox -回归分析，并准备Kaplan Meier （KM）图来可视化数据。结果：210例患者符合ARCI筛查标准。多变量分析发现ARCI与3年死亡率之间存在关联，风险比（HR）为1.732 （p = 0.019）。同时存在的慢性肝病（CLD）增加了这一相关性，HR为1.722 (p = 0.020)，但单独存在的CLD没有增加死亡风险，HR为1.223 （p = 0.401）。严重的ARCI与死亡率的相关性最强(p =结论：通过简单的床边试验确定的ARCI与早期死亡率显著相关。这种关系在肝病患者中更为明显。ARCI越严重，与死亡的关系越强，时间间隔为3年。研究对象的平均年龄为52岁，比一般人群诊断出认知障碍时的预期年龄小10岁。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alcohol and alcoholism 医学-药物滥用

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

4-8 weeks

期刊介绍： About the Journal Alcohol and Alcoholism publishes papers on the biomedical, psychological, and sociological aspects of alcoholism and alcohol research, provided that they make a new and significant contribution to knowledge in the field. Papers include new results obtained experimentally, descriptions of new experimental (including clinical) methods of importance to the field of alcohol research and treatment, or new interpretations of existing results. Theoretical contributions are considered equally with papers dealing with experimental work provided that such theoretical contributions are not of a largely speculative or philosophical nature.