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

Addiction. 2018 Apr;113(4):623-632. doi: 10.1111/add.14109. Epub 2018 Jan 6.

Abstract

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.

Keywords: Alcohol; Australasia; alcohol policy; alcohol-related presentations; emergency department; public health.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alcoholic Intoxication / epidemiology*
  • Alcoholism / diagnosis
  • Alcoholism / epidemiology*
  • Australia / epidemiology
  • Emergency Medical Services / statistics & numerical data
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Police / statistics & numerical data
  • Prospective Studies
  • Sex Factors
  • Wounds and Injuries / epidemiology*
  • Young Adult