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Cross-Sectional Study of Harmful Alcohol Use in Acutely Ill Pulmonary Patients Hospitalized in a Multidisciplinary Hospital

Journal «MEDICINA» ¹ 4, 2024, pp.17-42 (Research)

Authors

Nadezhdin A. V.
MD, PhD, Assistant Professor, Chair for Narcology1
ORCID: 0000-0003-3368-3170

Tetenova E. J.
MD, PhD, Assistant Professor, Chair for Narcology1
ORCID: 0000-0002-9390-621X

Petukhov A. E.
MD, PhD (Pharmacy), Assistant Professor, A.P. Arzamastsev Chair for Pharmaceutical and Toxicological Chemistry, A.P. Nelyubin Institute of Pharmacy2
ORCID: 0000-0002-4855-4235

Davydova E. N.
MD, Deputy Head Physician3

Zolotova E. A.
MD, Head, Pulmonology Department3

Michurina S. V.
MD, Pulmonologist3

1 - Russian Medical Academy of Continuous Professional Education, Moscow, Russian Federation
2 - Sechenov First Moscow State Medical University, Moscow, Russian Federation
3 - Demikhov Moscow Clinical Hospital, Moscow, Russian Federation

Corresponding Author

Nadezhdin Aleksei; e-mail: aminazin@inbox.ru

Conflict of interest

None declared.

Funding

The study had no sponsorship.

Abstract

Background. Harmful alcohol use is associated with increased risk and severity of outcomes in infectious diseases such as HIV/AIDS, tuberculosis, and pneumonia. Alcohol impairs the ability of lung tissue to respond adequately to inflammation, injury, and infection. General hospitals are considered a convenient setting for treating of individuals with alcohol use disorders. Aim of the study. To study the prevalence of alcohol consumption among acutely ill pulmonary patients, not requiring intensive care, hospitalized in a multidisciplinary urban clinical hospital, using screening self-questionnaires (AUDIT-4) and a highly sensitive and specific marker of chronic alcohol intoxication phosphatidylethanol (PEth). Materials and Methods. We studied the prevalence of alcohol use in pulmonary patients with regard to their socio-demographic characteristics. Statistical analysis was performed using IBM SPSS Statistics 25.0 software. We applied descriptive statistics and multivariate logistic regression model to estimate the impact of socio-demographic and diagnostic predictors on the dependent variable and control for confounders. Results. Peripheral blood PEth values of 0.3 μmol/L or more, indicating excessive alcohol consumption during the 24 weeks prior to hospitalization, were observed in 8.5% of pulmonary patients. 5.0% of patients admitted drinking alcohol during the day prior to hospitalization. The highest proportion of alcohol abusers (PEth ≥ 0.3 μmol/L) was observed among patients with pneumonia (Influenza and pneumonia (J09–J18)) – 10.7%. The results of the regression analysis showed that women were negatively associated with PEth level ≥ 0.3 μmol/L compared to men (AOR 0.269; CI 95% 0.139-0.519; p<0.001) and patients with diagnoses from the diagnostic rubric «Chronic lower respiratory diseases» (J40-J47) compared to the reference group of the diagnostic rubric «Influenza and pneumonia» (J09-J18) (AOR 0.537; CI 95% 0.296-0.974; p=0.041). There was a positive association with the level of PEth ≥ 0.3 μmol/L in patients who defined their employment status as «Inactive», compared with the reference group «Active» (AOR 2.268; CI 95% 1.191-4.320; p=0.013) and in individuals in psychological distress (SCL-5≥2) compared with those not in distress (SCL-5<2) (AOR 2.892; CI 95% 1.210-6.910; p=0.017). Significant positive association with a PEth level ≥0.3 μmol/L (OR 7.077; 95% CI 3.485–14.371; p <0.001) was observed in those who admitted drinking alcohol during the day prior to hospitalization compared with the reference group of those who answered negatively. Conclusions: Our findings support the need for brief anti-alcohol interventions in multidisciplinary hospital settings.

Key words

harmful alcohol use, AUDIT-4, phosphatidylethanol, community-acquired pneumonia, alcohol-related disease, pulmonary pathology, brief intervention

DOI

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