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

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

Author information

1
School of Clinical Sciences at Monash Health, Monash University, VIC, Australia.
2
Australasian College for Emergency Medicine, West Melbourne, VIC, Australia.
3
Chair of Road Trauma and Emergency Medicine, Australian National University Medical School, The Canberra Hospital, Australia.
4
Centre for Clinical Research in Emergency Medicine, Royal Perth Hospital, University of Western Australia, Australia.

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

PMID:
29155471
DOI:
10.1111/add.14109

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