Causes of death among veterans with alcohol use disorder‐related conditions: A 5‐year follow‐up study of Veterans Health Administration hospitalizations
James C. Willey, Shivali Patel, Bjarni Haraldsson, George Bailey, Andrea Holcombe, Amy M. J. O'Shea, Thad Abrams, Jeydith GutierrezAbstract
Background
Alcohol use disorder‐related (AUD) diagnoses are common among hospitalized Veterans. Our prior research found that the presence of any AUD‐related diagnosis during hospital admission is associated with a 30% 5‐year mortality rate.
Objective
To compare demographics and causes of death between hospitalized patients within the Veterans Health Administration (VHA) with and without AUD‐related diagnoses.
Methods
Cohort study of two populations of Veterans with and without AUD‐related conditions admitted to VHA hospitals from October 2015 to September 2020. National Death Index (NDI) data for all admitted patients were obtained to identify those who had died by December 2022. Among patients who died, those with AUD‐related diagnoses during the hospital stay were identified using the International Classification of Diseases, Tenth Revision (ICD‐10) codes and compared with those without AUD‐related diagnoses.
Results
Out of 1,149,107 patients admitted to VHA, 411,101 deaths were reported. Of these, 58,498 deaths (14.2%) involved patients with an AUD‐related diagnosis at admission and a median follow‐up of 5.4 years. Deceased patients with AUD‐related diagnoses were younger at study start (62.0 vs. 72.7 years) and had significantly higher odds of death among the 18–39 age group (odds ratio [OR]: 2.43; 95% confidence interval [CI]: 2.31, 2.57) compared with those without. Among causes of death, the biggest differences between the AUD‐related and non‐AUD‐related cohorts were gastrointestinal diseases (14.8% vs. 2.8%) and external causes (12.2% vs. 4.3%).
Conclusion
Veterans with AUD‐related conditions die younger than those without. This highlights the need for systems‐level approaches, including screening, brief interventions, and linkage to postdischarge services, to comprehensively treat AUD.