Alcohol‐related harm in emergency departments: a prospective, multi‐centre study

• DOI: 10.1111/add.14109
• Publication Date: 2017-11-20T15:46:44Z
• Authors: Diana Egerton‐War...; Andrew Gosbell; Katie Moore; Angela Wadsworth; Drew Richardson; Daniel M. Fatovich
• Keywords: Adult; Male; Emergency Medical Services; Biomedical and clinical sciences; emergency department; Adolescent; 150; 610; Young Adult; 03 medical and health sciences; Sex Factors; 0302 clinical medicine; 616; Psychology; Humans; Prospective Studies; Aged; Aged, 80 and over; Australasia; public health; Age Factors; Australia; Middle Aged; Police; 3. Good health; Alcoholism; alcohol-related presentations; Wounds and Injuries; alcohol policy; Female; Alcohol; Emergency Service, Hospital; 0305 other medical science; Alcoholic Intoxication; New Zealand

AbstractBackground and aimsEmergency 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].DesignMulti‐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.SettingEight EDs in Australia and New Zealand, representing differing hospital role delineations.ParticipantsA total of 8652 patients aged ≥ 14 years attended and 8435 (97.5%) were screened.MeasurementsThe 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.FindingsA 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).ConclusionsAlmost one in 10 presentations to emergency departments in Australia and New Zealand are alcohol related.