Should all patients be screened for #alcohol misuse at #hospital admission?

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Universal screening for alcohol misuse has been advocated in the past, but its feasibility has been questioned.

Universal screening for alcohol misuse at the time of hospital admission is not only feasible but identifies a cohort with frequent emergency department (ED) attendances, recurrent admissions and elevated risk of alcohol-related liver disease (ARLD).

That is the conclusion of the authors of a major new landmark study of 50,000 hospital admissions which appears in the Journal of Hepatology . Investigators systematically screened all admissions to the Acute Medical Unit of a large acute hospital in the UK using an electronic data capture system in real time. They classified 2-3 per cent of admissions as being at “increasing,” and 4 per cent at “high” risk of alcohol harm. High-risk patients had a distinct profile of admissions, with the most common diagnoses being mental health disorders, gastrointestinal bleeding, poisoning, and liver disease.

“Our study shows that universal screening for alcohol misuse among patients admitted to Acute Medical Units is both achievable and can help target interventions,” said lead investigator, Dr Richard Aspinall. “By classifying patients according to their risk of alcohol harm, we can ensure they receive the appropriate therapies that will potentially reduce the risk of further adverse events in future.

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