Mortality and cause of death in patients aged 50-59, 12 months after review by an alcohol care team

Introduction

Presentations to hospital with alcohol use disorder and alcohol-related liver disease (ArLD), as well as alcohol-specific mortality, continue to rise. We report mortality and cause of death (COD) for patients aged 50–59, 12 months after they were invited to take part in a service evaluation of an Alcohol Care Team (ACT).

Methods

Consecutive patients seen by the ACT at an acute NHS trust between January-April 2021 were invited to take part in a service evaluation. Baseline demographic and clinical data was collected in addition to community alcohol service referrals for all patients. Follow-up calls at 1- and 3-months post discharge obtained patient‘s views on the ACT and discussed alcohol use. Survival 12 months later was audited, and death certificates obtained to identify COD for those aged 50–59 years old, who were noted to be the largest cohort to have died.

Results

280 individuals were invited to take part in the original service evaluation. 12 months later, 41/280 (14.6%) participants had died. 64 participants aged 50–59 took part in the service evaluation and accounted for 15/41 deaths (36.5%), 3 of which occurred during the index admission. Death certificates were obtained for 8/15 of the 50–59-year-olds. The remaining 7 were not available via the General Register Office at the time of the audit. Of 8 patients for whom death certificates were obtained, 6/8 (75%) had ArLD (varyingly referred to as alcoholic liver disease or decompensated alcohol-related liver disease/cirrhosis) listed as a COD (5 in 1 a/b/c and 1 in part 2). Place of death for 7/8 patients was in hospital.

Discussion

Alcohol-specific deaths, of which 75% are attributed to ArLD, are highest in those aged 50–64 (ONS, 2021). Our results, while small, indicate a similar pattern, with ArLD listed as the COD in 75% of those aged 50–59. Place of death for many in this patient group remains in an acute hospital setting.