Abstract
BackgroundAlcohol is an important factor that contributes to emergency department (ED) visits due to injury. However, the role of alcohol in elderly patients visiting ED due to injury has not been clearly defined. This study aims to examine age and alcohol as risk factors of injury severity and clinical outcomes.MethodsThis study included patients who visited EDs between January 2011 and December 2016. Data was obtained from the Emergency Department-Based Injury In-depth Surveillance of the Korea Centers for Disease Control and Prevention, South Korea. Injury patients aged ≥18 years were included, but those who visited the ED more than 48 hours after injury, with unknown clinical outcomes (admission, mortality, and excess mortality ratio-adjusted injury severity score [EMR-ISS]) were excluded.ResultsWe analyzed 887,712 patients, of whom 131,708 (17.7%) non-elderly and 9,906 (7.0%) elderly had alcohol-related injury. Falls and slips are the most common injury mechanism (37.9%) in patients consuming alcohol (36.3% non-elderly/58.40% elderly). The injury occurred on roads (40.6%), houses (33.8%), and commercial facilities (11.9%) in elderly patients consuming alcohol. Suicide rate was 12.0% in elderly and 9.7% in non-elderly patients. According to the time of day of injury, evening (60.8%) was the most common in elderly and night (62.6%) in non-elderly patients. Admission rate (odds ratio [OR] 2.512 confidence interval [CI] 2.407–2.621), intensive care unit (ICU) care rate (OR 5.507 [CI] 5.178–5.858), mortality rate (OR 4.593 [CI] 4.086–5.162), and EMR-ISS >25 (OR 5.498 [CI] 5.262–5.745) were compared between patients with alcohol-related injury and non-elderly with non-alcohol-related injury patients. Alcohol consumption in elderly patients results in significant impairment and increases EMR-ISS, ICU care rate, and mortality rate. To reduce injury in elderly patients, alcohol screening, appropriate counseling, and intervention are needed.
Highlights
Injury is a public health problem accounting for 16% of the global disease burden
This study shows that alcohol-related injury had serious clinical outcomes in elderly patients
This study aimed to investigate the relationship between alcohol consumption and injury in elderly patients and to analyze the effect of alcohol on injury severity
Summary
Alcohol is an important contributing factor to injury-related emergency department (ED) visits and is the most commonly used and abused substance in the United States. It accounts for one in 10 deaths among adults aged 20–64 years (Fernandez et al, 2019). Alcohol is an important factor that contributes to emergency department (ED) visits due to injury. This study aims to examine age and alcohol as risk factors of injury severity and clinical outcomes. Injury patients aged ≥18 years were included, but those who visited the ED more than 48 hours after injury, with unknown clinical outcomes (admission, mortality, and excess mortality ratio-adjusted injury severity score [EMR-ISS]) were excluded. To reduce injury in elderly patients, alcohol screening, appropriate counseling, and intervention are needed
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