Universal screening for alcohol misuse at hospitalization is a feasible strategy

A study published online July 27, 2017 in the Journal of Hepatology has demonstrated that universal screening for alcohol misuse at the time of hospitalization to identify patients at risk of developing alcohol-related liver disease, is a feasible strategy.

Researchers from the UK screened all admissions to the Acute Medical Unit of a large acute hospital using an electronic data capture system. At the time of admission, information about the amount of alcohol consumed, previous visits and or admissions and whether they were alcohol-related was recorded.

Around 91% patients completed the screening; of these, around 3% of the patients were grouped as “increasing”, and 4% as “high” risk of alcohol harm. The high risk group had more frequent emergency room (ER) visits and higher re-admission rates; gastrointestinal bleeding, mental health disorders, poisoning and liver disease were the most common diagnoses for hospitalization.

What this study showed was that it is possible to screen patients for alcohol misuse at hospitalization, identify patients with a very high unit consumption and then to refer them for appropriate intervention, potentially reducing the burden of alcohol-related harm. While, lower risk patients can be given brief advice by any trained healthcare professional

This study assumes all the more importance because alcohol misuse is a major cause of preventable death. It also offers a solution to the unmet need to identify patients with alcohol-related liver disease at an earlier stage.

According to the WHO, 3.3 million deaths (~6% of all deaths) globally every year are due to alcohol-related harm. It is all the more worrisome because alcohol consumption causes death and disability relatively early in life, particularly in the younger age group. Alcohol has been linked to many noncommunicable diseases, including alcohol-related liver disease and injuries. Overall 5.1 % of the global burden of disease and injury is attributable to alcohol, as measured in disability-adjusted life years (DALYs).

Source

1.    Westwood G, et al. Universal screening for alcohol misuse in acute medical admissions is feasible and identifies patients at high risk of liver disease. Journal of Hepatology, published 27 July 2017.

Dr KK Aggarwal

National President IMA & HCFI

Recipient of Padma Shri, Dr BC Roy National Award, Vishwa Hindi Samman, National Science Communication Award & FICCI Health Care Personality of the Year Award

Vice President Confederation of Medical Associations of Asia and Oceania (CMAAO)

Past Honorary Secretary General IMA

Past Senior National Vice President IMA  

President Heart Care Foundation of India

Gold Medalist Nagpur University

Limca Book of Record Holder in CPR 10

Honorary Professor of Bioethics SRM Medical College Hospital & Research Centre  
Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand
Editor in Chief IJCP Group of Publications & eMedinewS

Member Ethics Committee Medical Council of India (2013-14)  

Chairman Ethics Committee Delhi Medical Council (2009-15)

Elected Member Delhi Medical Council (2004-2009)

Chairman IMSA Delhi Chapter (March 10- March 13)

Director IMA AKN Sinha Institute (08-09)
Finance Secretary IMA (07-08)
Chairman IMAAMS (06-07)
President Delhi Medical Association (05-06)