Alcohol use and in-hospital complications in patients aged ≥ 80 years admitted to Internal medicine: a multicentre observational study in Spain

Abstract

Background

Alcohol consumption among older adults aged ≥ 80 years remains insufficiently characterised, despite increased susceptibility to alcohol-related harm. This study aimed to assess the prevalence of alcohol use and alcohol use disorder (AUD) and to examine associations with in-hospital complications in patients aged ≥ 80 years admitted to Internal Medicine.

Methods

This multicentre prospective observational study was conducted from June 2022 to July 2023 across 19 hospitals. Consecutive patients aged ≥ 80 years admitted to Internal Medicine were included. Alcohol use was assessed through structured interviews and validated screening instruments, including the Alcohol Use Disorders Identification Test (AUDIT) and the CAGE questionnaire. Data on comorbidities, medication use, functional status, laboratory parameters, and in‐hospital complications were collected. Multivariable logistic regression was performed to identify independent predictors of in-hospital complications.

Results

A total of 916 patients (median age 86 years; 54% female) were analysed. Active alcohol use at admission was reported by 28%, and 8% met AUDIT criteria for AUD. Alcohol use was documented in medical records in 36% of cases. Overall, 47% developed ≥ 1 complication. Alcohol withdrawal syndrome (9%) and insomnia (36%) were significantly more frequent among active drinkers. Independent predictors of in-hospital complications included AUDIT score ≥ 8 [Odds Ratio (OR) 3.8; 95% Confidence Interval (CI) 1.8–8.3], in‐hospital benzodiazepine use (OR 2.3; 95% CI 1.7–3.2), neuroleptic use (OR 4.1; 95% CI 2.9–5.7), and discharge diagnoses of infection or neurological disease.

Conclusions

Alcohol consumption is common yet under-recognised in patients aged ≥ 80 years and is associated with increased odds of in‐hospital complications. Routine screening with the AUDIT in this population may improve risk stratification and facilitate early identification of patients at elevated risk of in-hospital complications.