Point prevalence of alcoholism in hospitalized patients: Continuing challenges of detection, assessment, and diagnosis

Objective: To measure a 1-day point prevalence of alcohol dependence among hospitalized patients and to assess practices of detection, evaluation, and diagnosis of alcohol problems. Patients and Methods: On April 27, 1994, a total of 795 adult inpatients at 2 midwestern teaching hospitals were asked to complete a survey that inclu ded the Self-administered Alcoholism Screening Test (SAAST). The records of SAAST-positive patients were reviewed to determine the numbers of patients receiving laboratory screening for alcoholism, addiction consultative serv ices, and a discharge diagnosis of alcoholism. Results: The survey response rate was 84% (667/795). Of the 569 patients wh o provided SAAST information, 42 (7.4%) had a positive SAAST score and thus were identified as alcohol dependent. Thirteen (31%) of the 42 alcoholic p atients received addiction or psychiatric consultative services during thei r hospitalization. Serum gamma -glutamyltransferase was measured in 4 (11%) of the 38 actively drinking alcoholic patients. Three (7%) of 42 alcoholic patients received a discharge diagnosis of alcohol abuse or dependence. Conclusions: The alcoholism prevalence rate was lower than those observed i n several other US hospitals. Laboratory testing may be underutilized in id entifying hospitalized patients who may be addicted to alcohol. Physician u se of consultative services and diagnosis of alcohol dependence had not imp roved from similar observations more than 20 years earlier. These findings may indicate persistent problems in physician detection, assessment, and di agnosis of alcoholism.