IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v9i5.2699 9:5:211 Outcomes in clinical subgroups of patients with alcohol-related hospitalizations: a population-based retrospective cohort study Friesen Erik 1 2 Mataruga Andrea 3 Nickel Nathan 4 Kurdyak Paul 3 2 Bolton James 4 5 Temerty Faculty of Medicine, University of Toronto Centre for Addiction and Mental Health (CAMH) Centre for Addiction and Mental Health (CAMH) Mental Health and Addiction Research Program, ICES Manitoba Centre for Health Policy Department of Psychiatry, Max Rady College of Medicine, University of Manitoba 18 09 2024 2024 9 5 2699 This work is licenced under a Creative Commons Attribution 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/2699 Objective and Approach

Individuals who experience alcohol-related hospitalizations are at a high risk of recurrent harm and premature mortality. This project characterized the clinical subgroups of individuals who experience alcohol-related hospitalizations to understand who is at the highest risk of recurrent harm following discharge.

 Approach

Population-based retrospective cohort study of individuals with an alcohol-related hospitalization between 2017-2018 in two Canadian provinces (Ontario and Manitoba) using linked provincial health administrative databases. Clinical subgroups were identified with latent class analysis based on the type and frequency of alcohol-related health service use in the two-years preceding the index hospitalization. Associations between subgroup membership, readmission, and mortality in the year following discharge were evaluated using multivariable time-to-event regression.

 Results

In cohorts of 4,753 (Manitoba) and 29,290 (Ontario) individuals, seven subgroups were identified. These followed a severity gradient from low-frequency service use for acute intoxication to high-frequency service use for alcoholic liver disease. Individuals in the ‘liver disease’ subgroup had the highest risk of 1-year mortality relative to the rest of the cohort (adjusted hazard ratio [aHR]: 3.83, 95% confidence interval (CI): 2.80-5.24). A small subgroup of individuals with a history of high-frequency alcohol-related health service had the highest hazard of readmission (aHR: 5.09, 95% CI: 4.11-6.31).

 Conclusions and Implications

There are distinct clinical subgroups of individuals who experience alcohol related hospitalizations and individuals with high-frequency health service use and alcohol-related liver disease are at the highest risk of readmission and mortality. These subgroups merit consideration in strategies aimed at reducing the risk of post-discharge harm.