Admissions of patients with alcohol intoxication in the Emergency Department: a growing phenomenon.

N Bertholet,A Adam,B Yersin,Jb Daeppen,M Faouzi,O Boulat,D Clerc

doi:10.4414/smw.2014.13982

Abstract

To investigate the change over time in the number of ED admissions with positive blood alcohol concentration (BAC) and to evaluate predictors of BAC level. We conducted a single site retrospective study at the ED of a tertiary referral hospital (western part of Switzerland) and obtained all the BAC performed from 2002 to 2011. We determined the proportion of ED admissions with positive BAC (number of positive BAC/number of admissions). Regression models assessed trends in the proportion of admissions with positive BAC and the predictors of BAC level among patients with positive BAC. A total of 319,489 admissions were recorded and 20,021 BAC tests were performed, of which 14,359 were positive, divided 34.5% female and 65.5% male. The mean (SD) age was 41.7(16.8), and the mean BAC was 2.12(1.04) permille (g of ethanol/liter of blood). An increase in the number of positive BAC was observed, from 756 in 2002 to 1,819 in 2011. The total number of admissions also increased but less: 1.2 versus 2.4 times more admissions with positive BAC. Being male was independently associated with a higher (+0.19 permille) BAC, as was each passing year (+0.03). A significant quadratic association with age indicated a maximum BAC at age 53. We observed an increase in the percentage of admissions with positive BAC that was not limited to younger individuals. Given the potential consequences of alcohol intoxication, and the large burden imposed on ED teams, communities should be encouraged to take measures aimed at reducing alcohol intoxication.

Highlights

Unhealthy alcohol use is consumption that is associated with negative health consequences, including abuse and dependence
Given the potential consequences of alcohol intoxication, and the large burden imposed on emergency department (ED) teams, communities should be encouraged to take measures aimed at reducing alcohol intoxication
Outcomes We considered three main outcomes: 1) proportion of ED admissions with positive blood alcohol concentration (BAC), 2) proportion of admissions with BAC >2 permille (BAC>2 permille/all admissions with positive BAC), and 3) BAC level as a continuous measure

Summary

Introduction

Unhealthy alcohol use is consumption that is associated with negative health consequences, including abuse and dependence. It is a major public health concern and accounts for a significant portion of the disease burden in Switzerland and worldwide [1,2,3,4]. In French-speaking Lausanne, the local media have reported a large increase in social problems and hospital admissions related to alcohol intoxication that corresponds to the clinical observations reported by ED staff. The media strongly focuses on young individuals (especially young males), but even if alcohol use has a strong disease burden on young men [1], it remains to be determined whether or not the alcohol-related ED admissions are mainly observed in young men or are more generally spread across age and sex. We evaluated the predictors of BAC level among patients with positive BAC

Methods

Results

Conclusion