Premium
Alcohol‐related harm in emergency departments: a prospective, multi‐centre study
Author(s) -
EgertonWarburton Diana,
Gosbell Andrew,
Moore Katie,
Wadsworth Angela,
Richardson Drew,
Fatovich Daniel M.
Publication year - 2018
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.14109
Subject(s) - medicine , alcohol use disorders identification test , emergency department , confidence interval , audit , prospective cohort study , medical record , alcohol intoxication , poison control , injury prevention , emergency medicine , family medicine , psychiatry , management , economics
Background and aims Emergency department (ED) alcohol‐related presentation data are not routinely collected in Australia and New Zealand. It is likely that previous research has underestimated the numbers of patients presenting with alcohol‐related conditions. This study aimed to quantify the level of alcohol harm presenting to EDs in Australia and New Zealand [Correction added on 23 Jan 2018, after first online publication: The ‘aims’ section was missing and is updated in this version]. Design Multi‐centre, prospective study. Patients were screened prospectively for alcohol‐related presentations during a 7‐day period in December 2014. Part 1 involved screening to determine alcohol‐positive ED presentations and data collection of patient demographic and clinical information. Part 2 involved a consent‐based survey conducted with patients aged ≥ 14 years to perform Alcohol Use Disorders Identification Test (AUDIT) scores. Setting Eight EDs in Australia and New Zealand, representing differing hospital role delineations. Participants A total of 8652 patients aged ≥ 14 years attended and 8435 (97.5%) were screened. Measurements The main outcome measure was the proportion of patients who had an alcohol‐related presentation termed ‘alcohol‐positive’, using pre‐defined criteria. It included injuries, intoxication, medical conditions and injuries caused by an alcohol‐affected third party. Secondary outcomes included demographic and clinical information, the type of alcohol‐related presentations and AUDIT scores. Findings A total of 801 [9.5%; 95% confidence interval (CI) = 8.9–10.1%] presentations were identified as alcohol‐positive, ranging between 4.9 and 15.2% throughout sites. Compared with alcohol‐negative patients, alcohol‐positive patients were more likely to be male [odds ratio (OR) = 1.90, 95% CI = 1.63–2.21], younger (median age 37 versus 46 years, P < 0.0001), arrive by ambulance (OR = 1.94, 95% CI = 1.68–2.25) or police/correctional vehicle (OR = 4.56, 95% CI = 3.05–6.81) and require immediate treatment (OR = 3.20, 95% CI = 2.03–05.06). The median AUDIT score was 16 (interquartile range = 10–24). Conclusions Almost one in 10 presentations to emergency departments in Australia and New Zealand are alcohol related.