Abstract：
OBJECTIVE: Alcohol use disorder (AUD) is a persistent public health concern, contributing significantly to mortality and morbidity. This study aims to evaluate the impact of in-hospital extended-release naltrexone (XR-NTX) administration on alcohol-related outcomes.
METHODS: This retrospective cohort study, conducted at an academic medical centre, included 141 adult patients with AUD who received XR-NTX between December 2020 and June 2021. Primary and secondary outcomes were assessed 90 days before and after XR-NTX administration to identify number of alcohol-related hospitalisations, emergency department (ED) visits and average length of hospital stay. Subgroup analyses assessed outcomes in high hospital utilisers and marginally housed or unhoused populations.
RESULTS: There was a significant decrease in ED visits and length of hospital stay post XR-NTX and no significant difference in the number of rehospitalisations. Subgroup analysis showed significant reduction in hospital readmissions and ED visits among high hospital utilisers. Our sample was a predominantly middle-aged, male and white patient population.
CONCLUSIONS: In-hospital initiation of XR-NTX for AUD was associated with a significant decrease in ED visits and length of hospital stay. While no significant impact on the number of hospitalisations was observed overall, there was a substantial reduction in hospital readmissions and ED visits among high utilisers. Our findings suggest the potential benefits of in-hospital XR-NTX, emphasising the need for further research to establish causal relationships, assess cost-effectiveness and explore effectiveness across diverse patient populations. Effective in-hospital interventions, such as XR-NTX, hold promise for improving patient outcomes and reducing the healthcare burden associated with AUD.
METHODS: This retrospective cohort study, conducted at an academic medical centre, included 141 adult patients with AUD who received XR-NTX between December 2020 and June 2021. Primary and secondary outcomes were assessed 90 days before and after XR-NTX administration to identify number of alcohol-related hospitalisations, emergency department (ED) visits and average length of hospital stay. Subgroup analyses assessed outcomes in high hospital utilisers and marginally housed or unhoused populations.
RESULTS: There was a significant decrease in ED visits and length of hospital stay post XR-NTX and no significant difference in the number of rehospitalisations. Subgroup analysis showed significant reduction in hospital readmissions and ED visits among high hospital utilisers. Our sample was a predominantly middle-aged, male and white patient population.
CONCLUSIONS: In-hospital initiation of XR-NTX for AUD was associated with a significant decrease in ED visits and length of hospital stay. While no significant impact on the number of hospitalisations was observed overall, there was a substantial reduction in hospital readmissions and ED visits among high utilisers. Our findings suggest the potential benefits of in-hospital XR-NTX, emphasising the need for further research to establish causal relationships, assess cost-effectiveness and explore effectiveness across diverse patient populations. Effective in-hospital interventions, such as XR-NTX, hold promise for improving patient outcomes and reducing the healthcare burden associated with AUD.
摘要：
目的：酒精使用障碍（AUD）是一个持续存在的公共卫生问题，对死亡率和发病率有显著影响。本研究旨在评估院内缓释纳曲酮（XR-NTX）给药对酒精相关结局的影响。
方法：这项回顾性队列研究，在学术医疗中心进行，纳入了141名在2020年12月至2021年6月期间接受XR-NTX的AUD成年患者。在XR-NTX给药之前和之后90天评估主要和次要结局，以确定与酒精相关的住院次数。急诊科（ED）就诊次数和平均住院时间。亚组分析评估了高医院使用率和边缘住房或无住房人群的结果。
结果：XR-NTX后，ED就诊次数和住院时间显着减少，而再住院次数没有显着差异。亚组分析显示，高医院使用率患者的再入院率和ED就诊率显着减少。我们的样本主要是中年人，男性和白人患者。
结论：住院开始XR-NTX治疗AUD与ED就诊次数和住院时间显著减少相关。虽然总体上对住院人数没有显著影响，高使用率患者的再入院率和急诊就诊率大幅下降.我们的研究结果表明，院内XR-NTX的潜在益处，强调需要进一步研究以建立因果关系，评估成本效益并探索不同患者人群的有效性。有效的住院干预措施，例如XR-NTX，有望改善患者预后并减轻与AUD相关的医疗负担。
方法：这项回顾性队列研究，在学术医疗中心进行，纳入了141名在2020年12月至2021年6月期间接受XR-NTX的AUD成年患者。在XR-NTX给药之前和之后90天评估主要和次要结局，以确定与酒精相关的住院次数。急诊科（ED）就诊次数和平均住院时间。亚组分析评估了高医院使用率和边缘住房或无住房人群的结果。
结果：XR-NTX后，ED就诊次数和住院时间显着减少，而再住院次数没有显着差异。亚组分析显示，高医院使用率患者的再入院率和ED就诊率显着减少。我们的样本主要是中年人，男性和白人患者。
结论：住院开始XR-NTX治疗AUD与ED就诊次数和住院时间显著减少相关。虽然总体上对住院人数没有显著影响，高使用率患者的再入院率和急诊就诊率大幅下降.我们的研究结果表明，院内XR-NTX的潜在益处，强调需要进一步研究以建立因果关系，评估成本效益并探索不同患者人群的有效性。有效的住院干预措施，例如XR-NTX，有望改善患者预后并减轻与AUD相关的医疗负担。
