A 5-year Follow-up of a Cohort of Italian Alcoholics: Hospital Admissions and Overall Survival

Background Alcohol-use disorders (AUDs), including alcohol dependence and alcohol abuse defined according to specific DSM-IV and ICD-X criteria, can be potentially lethal, since they are associated with several medical and psychiatric conditions. This study aims to describe the causes of hospitalization of a large cohort of subjects with alcohol dependence (alcoholics) enrolled in Florence (Italy) over a 5-year follow-up period and to evaluate the effect of hospitalization on overall survival. Methods Eleven-hundred-thirty (1,130) alcoholics, newly diagnosed from 1997-2001, were linked to the Regional Mortality Registry for update of vital status as of December 31, 2006 and to the Hospital Discharge electronic archives of the Regional Health System of Tuscany to verify hospital admissions during the 5-year post cohort enrollment follow-up. Kaplan-Meier survival and Cox regression analyses were performed to evaluate any association of hospital admission with overall survival. Results A total of 3,916 new hospitalizations occurred during the 5-year follow-up. Most alcoholics (70.6%) reported at least 1 new hospitalization, with a first hospitalization rate of 61.7 per 100 person-years in the first year of follow-up. The mean number of hospitalizations per admitted subject was 4.87 (SD:7.4) and mean length of hospital stay was 8.5 days (SD:11.3). The main causes of hospitalization were mental disorders and diseases of the digestive system, as well as accidents or violence. Among those alcoholics alive after 1 year of follow-up, a significantly increased risk of dying in the following years could be predicted by early hospitalization in the 12 months preceding (HR 1.73; 95% CI 1.15-2.60) or following (HR 3.59; 95% CI 2.31-5.61) enrollment in the cohort. Conclusions Our results confirm the association of AUDs with several serious medical conditions. This fact may be responsible for a high impact on health resource utilization and high social costs. Early hospitalization significantly predicts vital status at 5 years. This article is protected by copyright. All rights reserved.