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Aims:  This study compares the incidence and risk-markers of student alcohol intoxication-related emergency department (ED) visits and alcohol-related incidents reported to student affairs.  Methods:  Enrollment data were linked to ED visits with alcohol intoxication and to alcohol-related incidents reported to campus authorities within one year following the first (index) annual enrollment. Incidence, annual trends and associated risk markers were analyzed.  Results:  The cohort consisted of 204,423 students aged 16–49. Incidence rates of first ED visit with alcohol intoxication and alcohol-related incidents were 59/10,000 and 311/10,000 person-years, respectively. Both outcomes shared common risk-markers including age, gender, race/ethnicity, fraternity and sorority (FSL) membership, an existing diagnosis of depression, etc. Being an athlete was associated with a lower risk of alcohol-related ED visits, and transfer students were at lower risk for alcohol-related incidents.  Conclusion:  Linking enrollment data with hazardous drinking events can help in better monitoring of student hazardous drinking and targeting interventions.HighlightsFirst longitudinal study documenting the incidence of extreme student alcohol misuse.There were rising trends in student risky drinking based on two independent datasets.Analysis identified a range of risk markers predictive of risky drinking behaviors.Linking multiple student datasets can timely identify high risk students. First longitudinal study documenting the incidence of extreme student alcohol misuse. There were rising trends in student risky drinking based on two independent datasets. Analysis identified a range of risk markers predictive of risky drinking behaviors. Linking multiple student datasets can timely identify high risk students.

Trends and risk markers of student hazardous drinking: a comparative analysis using longitudinally linked datasets in a public university