The association of alcohol use with all-cause and cardiovascular disease-related hospitalizations or death in older, high-risk Veterans.

Blalock DV, Grubber J, Smith VA, Zulman DM, Weidenbacher HJ, Greene L, Dedert EA, Maciejewski ML. The association of alcohol use with all-cause and cardiovascular disease-related hospitalizations or death in older, high-risk Veterans. Alcoholism, clinical and experimental research. 2021 Jun 1; 45(6):1215-1224.

Related HSR&D Project(s)

• IIR 18-019 – Measuring the Longitudinal Relationshipsbetween Obesity, Weight Management Intervention, and Medical Expenditure
• IIR 15-316 – Care Coordination for High-Risk Patients with Multiple Chronic Conditions
• CDA 19-035 – Telehealth Treatment of Veterans with Alcohol Misuse at Risk for Cardiovascular Disease
• IIR 15-301 – The Effect of Reduction and Standardization of Reimbursements in the VA Fee-Basis Program: Impact on Quality of Care and Health Outcomes

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Abstract:

BACKGROUND: The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population. METHODS: We examined the association between alcohol use (measured by a screening instrument in primary care) and rates of all-cause and cardiovascular disease (CVD)-related 6-month hospitalization or death via electronic health records (EHRs) in a nationally representative sample of older, high-risk Veterans. Models were adjusted for sociodemographic and clinical characteristics, including frailty and comorbid conditions. RESULTS: The all-cause hospitalization or death rate at 6 months was 14.9%, and the CVD-related hospitalization or death rate was 1.8%. In adjusted analyses, all-cause hospitalization or death was higher in older Veterans who were nondrinkers or harmful use drinkers compared to moderate use drinkers, but CVD-related hospitalization or death was similar in all categories of drinking. CONCLUSIONS: These findings suggest that the complex association between alcohol and all-cause acute healthcare utilization found in the broader population is similar in older, high-risk Veteran patients. These findings do not support an association between alcohol consumption and CVD-specific hospitalizations.