Clinical trial NCT04973202: Portrayal of Hospital Alcohol Detoxification in France
Official title: Portrayal of Hospital Alcohol Detoxifications and Factors Associated With Longer or Ulterior Hospitalizations in France From 2011 to 2020
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Alcohol Use Disorder
Addiction
Alcohol Withdrawal Syndrome
Keywords: National portrayal of hospital alcohol detoxification in France
Rehabilitation in France
Alcohol in French hospitals and clinics
Alcohol detoxification
Lead sponsor: University Hospital, Montpellier
Sponsor class: OTHER
First posted: 2021-07-22
Enrollment: 50000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: French patients hospitalized for alcohol detoxification from 2011 to 2020

Brief summary: Even if hospital alcohol detoxifications are frequent in France, their caracteristicscharacteristics remain unknown. The investigators aim to describe the clinical and paraclinical caracteristicscharacteristics of their patients, their length and geographical repartition, etc... The investigators also aim to evaluate factors associated with longer stays or ulterior re-hospitalization for the same reason. Finally, The investigators aim to compare the stays by facility type.

Detailed description: Context:

In France, the consequences of excessive alcohol use are one of the primary reasons for hospitalization. When stopping the substance, patients with an alcohol use disorder can suffer from a potentially fatal alcohol withdrawal syndrome. To mitigate these risks, a withdrawal under medical supervision is possible, either in an outpatient setting or in hospital, where the detoxification can be programmed or imposed. In the course of an alcohol dependent patient's life, re-drinking is not exceptional and the patient may undergo several withdrawals during his or her life.

Psychiatric pathologies, especially anxiety and depression, are more frequent in these patients than in the rest of the population, just as can be somatic pathologies.e. Withdrawal accidents, represented by comital seizures and delirium tremens, can be critical.

In hospital detoxifications, studies do not show any benefit in continuing the stay beyond 10 days, except in the case of somatic or psychiatric complication. However, little information is available on the average length of stay for hospital alcohol detoxification.

Although alcohol dependence issues are very frequent and the resulting withdrawals are relatively common and associated with numerous comorbidities, little data exists at a national level in France.

The aim of this study is to describe these hospital detoxifications: course, duration, frequency and clinical and paraclinical characteristics of the patients. We also wish to analyze which characteristics are associated with longer stays or re-hospitalization and to compare the care according to the facility type.

Objectives:

Main:

- To describe the clinical, paraclinical, and stay characteristics of hospital alcohol detoxification in France

Secondary:

* To describe the regional distribution of hospital alcohol detoxification
* To evaluate whether certain clinical characteristics are associated with a longer hospital stays
* To evaluate whether certain clinical characteristics are associated with subsequent re-hospitalization for the same reason
* To compare the characteristics of patient stays by type of facility

Methods:

In this descriptive observational study using pre-existing data accessed via the PMSI (Programme de Médicalisation des Systèmes d'Information), we will use all hospital stays from 2011 to 2020 for alcohol detoxification in France, both in public and private settings.

For each hospital stay will be collected the length, the antecedents of hospital alcohol detoxification, clinical and psychiatric comorbidities, withdrawals complication, alcohol use complication, further examinations.

We will describe the stays using median and quartiles for continuous variables and number and percentage for dichotomous variables. For secondary objectives, we will use a multivariate linear regression model if the length of stay is normal, an ordinal regression model otherwise. The characteristics of the stays will be compared regarding the type of facility using univariate comparative tests: Chi² or Fisher for dichotomous variables and Student or Mann-Whitney for continuous variables.

Eligibility criteria: Inclusion criteria:

Inclusion criteria:

* French patients of at least 18 years old
* Inpatients of a public or private care facility for alcohol detoxification
* From 01/01/2011 to 12/31/2020
* In a medical or psychiatric hospital

Exclusion criteria:

- age \< 18 years

Primary outcomes:
measure: description of age
timeFrame: day 1 (At hospital inclusion)
measure: description of sex
timeFrame: day 1 (At hospital inclusion)
Secondary outcomes:
measure: description of geographic code
timeFrame: day 1 (At hospital inclusion)
measure: description of CMU-C
timeFrame: day 1 (At hospital inclusion)
measure: Length of stay
timeFrame: During the stay (day 1 - day 15)
measure: Care establishment
timeFrame: During the stay (day 1 - day 15)
measure: Number of previous hospital detoxification stays in the studied period
timeFrame: During the stay (day 1 - day 15)
measure: Psychiatric comorbidities
timeFrame: During the stay (day 1 - day 15)
measure: Withdrawal complication
timeFrame: During the stay (day 1 - day 15)
measure: Further examination
timeFrame: During the stay (day 1 - day 15)
measure: Re-hospitalization for same reason
timeFrame: day 1
Other outcomes:
Locations:
city: Montpellier
country: France
facility: Uhmontpellier
Study officials:
affiliation: University Hospital, Montpellier
name: Lionel MOULIS
role: PRINCIPAL_INVESTIGATOR
References: