The Prevalence of Alcohol Misuse Among Acute Admissions: Current Experience and Historical Comparisons

Abstract

Background Over the last 25 years there has been a large increase in alcohol related deaths in Scotland. Medical patients who misuse alcohol may have overt alcohol related disease, but may also present with other unrelated illness. Aim We examined alcohol misuse amongst acute medical admissions to compare this with other similar studies at the same hospital since 1974. Patients and Methods 850 consecutive admissions to the medical receiving unit of Victoria Infirmary were assessed. They were assessed using the modified Michigan Alcohol Screening Test (MAST) and also by a medical consultant. 414 patients also had their blood ethanol levels measured on admission. Results 18.6% admissions had a MAST greater than 5 and were considered to misuse alcohol (24.8% male and 12.2% female; p<0.0001). Patients from socio-economic group V and patients presenting with gastro-intestinal haemorrhage or self-poisoning were more likely to misuse alcohol. The sensitivity and specificity of consultant opinion regarding alcohol misuse were 0.55 and 0.97 compared with the MAST. There was an increase in the alcohol misuse amongst women admitted (12.2%) compared to 1977 (5.5%; p=0.0026) and 1981/2 (6.3%; p=0.004). Conclusion Alcohol misuse is common amongst acute medical admissions. Since 1979, there has been a particular increase in female medical admissions who misuse alcohol. Medical opinion regarding alcohol misuse lacks sensitivity in identifying at risk individuals compared with a validated questionnaire.