Alcohol Use Disorder Identification And Outcomes (AUDIO Trial)

Background: Hazardous alcohol consumption is a significant issue for the Irish healthcare system, leading to frequent hospitalisations and rising rates of chronic alcohol related disease. The complex interaction between physical harms and social problems makes this a difficult population to study. Aims and Objectives: We aimed to describe alcohol consumption in the population of patients attending hepatology services at Mater Misericordiae University Hospital (MMUH). The aim of our outpatient review was to provide an overview of alcohol consumptions patterns. An in-depth prospective study was conducted on patients admitted with an alcohol attributable illness, assessing demographics, biochemical, quality of life, cognitive and frailty scores. The primary outcome was six month mortality, with secondary outcomes of outpatient attendance, abstinence and changes in scores at follow-up. Methods: Routine data collected on all new patient referrals between May 2022 and 2023 was reviewed. This was followed by a 1 year prospective study between November 2022 and 2023 of 60 patients admitted under MMUH gastroenterology. Demographics, alcohol consumption data, frailty, quality of life, and cognitive assessments collected. Follow-up occurred at one, three and six months. Experimental analysis pertaining to extracellular vesicles (EV) was performed, to assess correlation with clinical data. Results: Hazardous alcohol consumers in both populations were males consuming a mixture of alcohol in a variety of locations. In the inpatient study, 78.3% were men aged 53.82 years, consuming a median 120 units per week. Six month mortality was 11.7%. Readmission rates were high (61.4%) with low rates of abstinence (10%) and follow up (55%). Patients were frail with moderate-low quality of life scores and mild cognitive impairment. EV analysis showed no significant associations with collected data. Conclusions: This young, frail cohort with frequent hospitalisations have a high six month mortality, high readmission, low follow-up and alcohol abstinence rates. More needs to be done to improve outcomes in this cohort.