Hospitalization More Common Among Heavy Drinkers

Pauline Anderson, July 9, 2009

Compared with teetotalers, men who consume 22 or more units of alcohol per week have a 20% higher rate of acute admissions for, among other health problems, alcohol-related conditions and mental-health disorders, new research shows.

The study also uncovered a 58% higher use of hospital beds among the heaviest drinkers but determined that nondrinkers were the most likely to be in hospital for coronary artery disease (CAD).

The study was published online July 1 in the Journal of Epidemiology and Community Health.

The study included 5772 men aged 35 to 64 years in 3 communities in Scotland who completed a workplace questionnaire and underwent a health screening examination between 1970 and 1973.

Part of the questionnaire centered on consumption of alcohol — wine, spirits, or beer. Consumption was converted into units that were divided into categories: none; 1 – 7, 8 – 14, 15 – 21, 22 – 34, and 35 or more units per week. About 32% of the men said they consumed no alcohol and 9% reported drinking 35 or more units per week.

Cancer, Psychoses Common Admission Causes

From computerized hospital-discharge records from 1972 to the end of 2005, researchers collected information on the number of acute admissions per person, the length of stay for each admission, and total number of bed days.

Causes of alcohol-related hospital admission included cancers of the mouth, pharynx, esophagus, liver, and larynx, alcoholic psychoses, chronic liver disease, and cirrhosis. For mental-health admissions, about 17% could be categorized as depression or anxiety and about 18% as psychoses.

After a follow-up of about 28 years, the study found that men who drank 22 or more units of alcohol per week had a higher rate of acute hospital admissions. Compared with nondrinkers, the age-adjusted rate ratios were 1.24 (95% CI, 1.13 – 1.37) for men drinking 22 to 34 units per week and 1.22 (95% CI, 1.10 – 1.35) for those drinking 35 or more units per week.

After adjustment for other risk factors, including father’s social class, the subjects’ social class, education, cholesterol, smoking, and angina, the association remained only for those drinking 22 to 34 units of alcohol per week.

Respiratory Disorders

Consumers of 22 or more units per week had higher rates of admissions for respiratory-related disorders, although adjustments for risk factors eliminated this relationship. This category of drinkers also had more mental health–related admissions and number of bed days.

Men consuming 15 or more units per week had higher admissions due to stroke and more bed days, with rates increasing with the amount consumed, even after adjustment for all risk factors.

Consuming 8 or more units weekly was associated with a greater number of bed days and, again, the rates increased with consumption. Compared with nondrinkers, the highest drinking category had a rate of 1.58 (95% CI, 1.37 – 1.83).

Alcohol-related admissions and number of bed days generally increased with alcohol consumption, with the higher category of consumers having a 3- to 4-fold higher rate than nondrinkers.

Nondrinkers and CAD

The study found that nondrinkers had the highest rate of admissions for coronary heart disease. The authors speculate that this could be due to a protective health effect of alcohol but also because patients who drink heavily may be more likely to die of sudden cardiac arrest before being admitted to the hospital.

The authors, from the University of Glasgow and the University of Bristol in the United Kingdom, said the increase in hospital admissions and bed use among people who drink alcohol has an important economic impact. “Alcohol consumption has a notable effect on health-service utilization and therefore [National Health Service] NHS costs,” they write.

Dr. C. L. Hart was funded by NHS Health Scotland. No competing interests were reported.

J Epidemiol Community Health. Published online July 1 2009. Abstract