Hospital Readmission and Mortality Among Alcohol-related Cancer Survivors With an Alcohol Use Disorder Diagnosis.

Abstract

Unhealthy alcohol use, which includes alcohol use disorder (AUD), is common among cancer survivors and can lead to negative health outcomes. Prior research found that an AUD diagnosis is associated with hospital readmission up to 180 days after discharge among alcohol-related cancer survivors. This study investigates whether AUD diagnosis is associated with hospital readmission 30 and 90 days after discharge and in-hospital mortality. We conducted a retrospective cohort study using the all-payer Nationwide Readmissions Database (NRD) from 2017 to 2020. We identified hospitalized adults with a history of alcohol-related cancer and stratified them by AUD diagnosis status. We applied 1:1 propensity score matching to balance measured demographic and clinical characteristics. We used logistic regression models to assess the association between AUD diagnosis and 30-day and 90-day readmission and mortality and Cox proportional hazards models to estimate time to readmission and mortality. Among 70,731 alcohol-related cancer survivors, 3067 (4.34%) had an AUD diagnosis. In the matched cohort (n=2916), AUD diagnosis was significantly associated with increased odds of 90-day readmission (odds ratio [OR], 1.150; 95% CI, 1.021-1.295) but was not significantly associated with 30-day readmission (OR, 1.102; 95% CI, 0.888-1.368) or mortality (OR, 1.102; 95% CI, 0.888-1.368). Hospitalized cancer survivors with AUD are at a higher risk for 90-day readmission. Findings from this and prior studies underscore the need for targeted postdischarge interventions to reduce the risk of long-term readmission in this population.