Who Leaves Early? Factors Associated With Against Medical Advice Discharge During Alcohol Withdrawal Treatment.
J Addict Med
; 12(6): 447-452, 2018.
Article
em En
| MEDLINE
| ID: mdl-29939873
ABSTRACT
OBJECTIVE:
To determine if certain patient, clinical, and disease factors are associated with against medical advice (AMA) discharge among patients admitted for treatment of alcohol withdrawal.METHODS:
Data from admissions to a dedicated unit for treatment of substance withdrawal were collected over a 6-month period. Patients with AMA and planned discharge were compared with regard to demographics, clinical data, and substance use disorder disease characteristics. A stepwise logistic regression was used to find the best model.RESULTS:
The study population included 655 patient encounters. A total of 93 (14%) discharges were AMA. Bivariate analysis showed patients with AMA discharge were younger (mean age 43 vs 46 years; Pâ<â0.05), more likely to leave on a Tuesday to Thursday, and to have an initial withdrawal score at or above the median (AMA 69% vs planned 56%; Pâ=â0.02). Emergency department (ED) admissions had an AMA discharge rate of 21% compared with 10% of community admissions (Pâ<â0.05). Regression analysis found AMA discharge was significantly associated with admission from the ED (odds ratio [OR] 2.03, confidence interval [CI] 1.27-3.25) and younger age (OR 0.97, CI 0.95-0.99). There was no significant difference in discharge disposition among patients with concurrent opioid use disorder who were on opioid agonist therapy.CONCLUSIONS:
AMA discharges occurred in 1 of every 7 admissions. Being admitted from the ED and younger age was associated with AMA discharge. No other patient or clinical factors were found to be associated with AMA discharge.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Alta do Paciente
/
Síndrome de Abstinência a Substâncias
/
Recusa do Paciente ao Tratamento
/
Transtornos Relacionados ao Uso de Álcool
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Addict Med
Ano de publicação:
2018
Tipo de documento:
Article