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

Nicolas Bertholet; Angéline Adam; Mohamed Faouzi; Olivier Boulat; Bertrand Yersin; Jean-Bernard Daeppen; David Clerc

doi:10.4414/smw.2014.13982

Original article

Vol. 144 No. 3132 (2014)

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

Nicolas Bertholet
Angéline Adam
Mohamed Faouzi
Olivier Boulat
Bertrand Yersin
Jean-Bernard Daeppen
David Clerc

DOI: https://doi.org/10.4414/smw.2014.13982
Cite this as:: Swiss Med Wkly. 2014;144:w13982
Published: 27.07.2014

Summary

QUESTION UNDER STUDY: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

References

Rehm J, et al. Alcohol consumption and alcohol-attributable burden of disease in Switzerland, 2002. Int J Public Health. 2007;52(6):383–92.
Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Res Health. 2011;34(2):135–43.
Shield KD, et al. Alcohol-attributable burden of disease and injury in Canada, 2004. Int J Public Health. 2012;57(2):391–401.
Whiteford HA, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86.
McGinnis JM, Foege WH. Mortality and morbidity attributable to use of addictive substances in the United States. Proc Assoc Am Physicians. 1999;111(2):109–18.
Shield KD, et al. Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption. Popul Health Metr. 2012;10(1):9.
Kuntsche E, Gmel G. Alcohol consumption in late adolescence and early adulthood – where is the problem? Swiss Med Wkly. 2013;143:w13826.
Pirmohamed M, et al. The burden of alcohol misuse on an inner-city general hospital. Qjm. 2000;93(5):291–5.
Verelst S, et al. Emergency department visits due to alcohol intoxication: characteristics of patients and impact on the emergency room. Alcohol Alcohol. 2012;47(4):433–8.
Imlach Gunasekara F, et al. How do intoxicated patients impact staff in the emergency department? An exploratory study. N Z Med J. 2011;124(1336):14–23.
Haberkern M, Exadaktylos AK, Marty H. Alcohol intoxication at a university hospital acute medicine unit – with special consideration of young adults: an 8-year observational study from Switzerland. Emerg Med J. 2010;27(3):199–202.
Gmel G, et al. Injury and repeated injury – what is the link with acute consumption, binge drinking and chronic heavy alcohol use? Swiss Med Wkly. 2007;137(45–46):642–8.
Gmel G, et al. Who drinks most of the total alcohol in young men – risky single occasion drinking as normative behaviour. Alcohol Alcohol. 2008;43(6):692–7.
O’Farrell A, et al. The burden of alcohol misuse on emergency in-patient hospital admissions among residents from a health board region in Ireland. Addiction. 2004;99(10):1279–85.
Pletcher MJ, Maselli J, Gonzales R. Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey. Am J Med. 2004;117(11):863–7.
Murphy JG, Correia CJ, Barnett NP. Behavioral economic approaches to reduce college student drinking. Addict Behav. 2007;32(11):2573–85.
Schuckit MA, et al. The time course of development of alcohol-related problems in men and women. J Stud Alcohol. 1995;56(2):218–25.
Neves P, Neuffer N, Yersin B. Massive alcoholic poisoning in the emergency department: how many, who, what and how? Rev Med Suisse. 2011;7(302):1445–9.
Sommers MS, et al. Emergency Department-Based Brief Intervention to Reduce Risky Driving and Hazardous/Harmful Drinking in Young Adults: A Randomized Controlled Trial. Alcohol Clin Exp Res. 2013;37(10):1753–62.
D’Onofrio G, et al. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012;60(2):181–92.
Schwan R, et al. Usefulness of brief intervention for patients admitted to emergency services for acute alcohol intoxication. Eur J Emerg Med. 2012;19(6):384–8.
Rice P, Drummond C. The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK. Br J Psychiatry. 2012;201(3):169–71.
Lhachimi SK, et al. Health impacts of increasing alcohol prices in the European Union: a dynamic projection. Prev Med. 2012;55(3):237–43.
Academic, E.D.S.R.C., The impact of screening, brief intervention and referral for treatment in emergency department patients’ alcohol use: a 3–, 6– and 12–month follow-up. Alcohol Alcohol. 2010;45(6):514–9.

How to Cite

1.

Bertholet N, Adam A, Faouzi M, Boulat O, Yersin B, Daeppen J-B, Clerc D. Admissions of patients with alcohol intoxication in the Emergency Department: a growing phenomenon. Swiss Med Wkly [Internet]. 2014 Jul. 27 [cited 2024 Apr. 19];144(3132):w13982. Available from: https://smw.ch/index.php/smw/article/view/1891

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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[1] Rehm J, et al. Alcohol consumption and alcohol-attributable burden of disease in Switzerland, 2002. Int J Public Health. 2007;52(6):383–92.

[2] Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Res Health. 2011;34(2):135–43.

[3] Shield KD, et al. Alcohol-attributable burden of disease and injury in Canada, 2004. Int J Public Health. 2012;57(2):391–401.

[4] Whiteford HA, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86.

[5] McGinnis JM, Foege WH. Mortality and morbidity attributable to use of addictive substances in the United States. Proc Assoc Am Physicians. 1999;111(2):109–18.

[6] Shield KD, et al. Global burden of injuries attributable to alcohol consumption in 2004: a novel way of calculating the burden of injuries attributable to alcohol consumption. Popul Health Metr. 2012;10(1):9.

[7] Kuntsche E, Gmel G. Alcohol consumption in late adolescence and early adulthood – where is the problem? Swiss Med Wkly. 2013;143:w13826.

[8] Pirmohamed M, et al. The burden of alcohol misuse on an inner-city general hospital. Qjm. 2000;93(5):291–5.

[9] Verelst S, et al. Emergency department visits due to alcohol intoxication: characteristics of patients and impact on the emergency room. Alcohol Alcohol. 2012;47(4):433–8.

[10] Imlach Gunasekara F, et al. How do intoxicated patients impact staff in the emergency department? An exploratory study. N Z Med J. 2011;124(1336):14–23.

[11] Haberkern M, Exadaktylos AK, Marty H. Alcohol intoxication at a university hospital acute medicine unit – with special consideration of young adults: an 8-year observational study from Switzerland. Emerg Med J. 2010;27(3):199–202.

[12] Gmel G, et al. Injury and repeated injury – what is the link with acute consumption, binge drinking and chronic heavy alcohol use? Swiss Med Wkly. 2007;137(45–46):642–8.

[13] Gmel G, et al. Who drinks most of the total alcohol in young men – risky single occasion drinking as normative behaviour. Alcohol Alcohol. 2008;43(6):692–7.

[14] O’Farrell A, et al. The burden of alcohol misuse on emergency in-patient hospital admissions among residents from a health board region in Ireland. Addiction. 2004;99(10):1279–85.

[15] Pletcher MJ, Maselli J, Gonzales R. Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey. Am J Med. 2004;117(11):863–7.

[16] Murphy JG, Correia CJ, Barnett NP. Behavioral economic approaches to reduce college student drinking. Addict Behav. 2007;32(11):2573–85.

[17] Schuckit MA, et al. The time course of development of alcohol-related problems in men and women. J Stud Alcohol. 1995;56(2):218–25.

[18] Neves P, Neuffer N, Yersin B. Massive alcoholic poisoning in the emergency department: how many, who, what and how? Rev Med Suisse. 2011;7(302):1445–9.

[19] Sommers MS, et al. Emergency Department-Based Brief Intervention to Reduce Risky Driving and Hazardous/Harmful Drinking in Young Adults: A Randomized Controlled Trial. Alcohol Clin Exp Res. 2013;37(10):1753–62.

[20] D’Onofrio G, et al. A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012;60(2):181–92.

[21] Schwan R, et al. Usefulness of brief intervention for patients admitted to emergency services for acute alcohol intoxication. Eur J Emerg Med. 2012;19(6):384–8.

[22] Rice P, Drummond C. The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK. Br J Psychiatry. 2012;201(3):169–71.

[23] Lhachimi SK, et al. Health impacts of increasing alcohol prices in the European Union: a dynamic projection. Prev Med. 2012;55(3):237–43.

[24] Academic, E.D.S.R.C., The impact of screening, brief intervention and referral for treatment in emergency department patients’ alcohol use: a 3–, 6– and 12–month follow-up. Alcohol Alcohol. 2010;45(6):514–9.