Abstract
Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.Design and MethodsWe selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.ResultsThe PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%.Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701]
Highlights
Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging
The codes used include any of the Australian clinical implementations of the International Classification of Diseases (ICD) 9th revision, ICD-10th revision (ICD10-AM) or the Systematized Nomenclature of Medicine—Clinical Terminology (SNOMED CT) [25,26], depending on the system used at the hospital
Over half the presentations arrived on weekdays (61%), and half arrived between 6 AM and 9.59 PM (55%)
Summary
Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. With an estimated 4–14% of emergency department (ED) presentations in Australia involving excessive alcohol consumption, depending on the time of the week, the ED remains a key setting in responding to alcohol harms [4,5,6]. Such harms range from acute intoxication and poisoning to life-threatening events due to intoxication (e.g. respiratory distress), injuries from alcohol-related accidents and assaults and chronic alcohol misuse problems (e.g. withdrawal) [3]. These study designs can be costly, Received 19 April 2016; accepted for publication 23 June 2016
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