Associations Between Readmission and Length of Stay in the Acute Admission Unit for Patients with Alcohol-Related Diagnoses–A Cohort Study

Patients with an alcohol-related diagnosis in emergency departments (EDs) are at high risk of readmission. Evidence shows an association between alcohol-related admissions and a wide range of diseases and disorders. Understanding the risk factors for readmission and the association with length of stay in the ED may help identify those who would benefit from targeted interventions. Thus, the hypothesis of this study is that patients with alcohol-related diagnoses and a short length of stay in the ED have a higher risk for readmission. Therefore, this study aimed to investigate the association between length of stay in the ED and 30-day readmission for patients with alcohol-related acute admissions, as well as to uncover possible risk factors for 30-day readmission. The study used a retrospective cohort design and was carried out from March 1, 2019, to January 31, 2020. The inclusion criteria were being at least 18 years old, admitted to an ED, and having an alcohol-related primary or secondary diagnosis (based on International Statistical Classification of Diseases and Related Health Problems, 10th ed. [ICD-10] codes). Patients were followed for 30 days after discharge from initial hospitalization to identify associations between length of stay and 30-day readmission. We included 1,174 patients and found that 17% (95% CI [15, 20]) of the patients admitted with an alcohol-related primary or secondary diagnosis were readmitted within 30 days. The hazard ratio (HR) for readmission increased with length of stay when compared with admission ≤24 hours; admission >24-48 hours HR 1.50 (95% CI [1.08, 2.08]), admission >48 hours HR 2.08 (95% CI [1.23, 3.52]). The study revealed that patients with alcohol-related diagnoses were at a higher risk of ED readmission the longer they stayed in the ED. Furthermore, the risk of readmission increased if patients had a medical or psychiatric diagnosis before admission or lived alone.