Emergency Department Frequent Users for Acute Alcohol Intoxication

Lauren R Klein, Marc L Martel, Brian E Driver, Mackenzie Reing, Jon B Cole, Lauren R Klein, Marc L Martel, Brian E Driver, Mackenzie Reing, Jon B Cole

Abstract

Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described.

Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters.

Results: We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169). Frequent users were older (47 years vs. 39 years), and more commonly male (86% vs. 71%). Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder.

Conclusion: In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. There are no conflicts of interest or sources of funding to declare.

Figures

Figure
Figure
Patient inclusion and exclusion in study examining frequency of emergency department use by those with acute alcohol intoxication.

References

    1. LaCalle E, Rabin E. Frequent users of emergency departments: the myths, the data, and the policy implications. Ann Emerg Med. 2010;56(1):42–8.
    1. Doupe MB, Palatnick W, Day S, et al. Frequent users of emergency departments: developing standard definitions and defining prominent risk factors. Ann Emerg Med. 2012;60(1):24–32.
    1. Locker TE, Baston S, Mason SM, Nicholl J. Defining frequent use of an urban emergency department. Emerg Med J. 2007;24(6):398–401.
    1. Pines JM, Asplin BR, Kaji AH, et al. Frequent users of emergency department services: gaps in knowledge and a proposed research agenda. Acad Emerg Med. 2011;18(6):e64–9.
    1. Leporatti L, Ameri M, Trinchero C, et al. Targeting frequent users of emergency departments: Prominent risk factors and policy implications. Health Policy. 2016;120(5):462–70.
    1. Whiteman PJ, Hoffman RS, Goldfrank LR. Alcoholism in the emergency department: an epidemiologic study. Acad Emerg Med. 2000;7(1):14–20.
    1. Thornquist L, Biros M, Olander R, et al. Health care utilization of chronic inebriates. Acad Emerg Med. 2002;9(4):300–8.
    1. Biros MH. The frequency of unsuspected minor illness or injury in intoxicated patients. Acad Emerg Med. 1996;3(9):853–8.
    1. Mullins PM, Mazer-Amirshahi M, Pines JM. Alcohol-Related Visits to US Emergency Departments, 2001–2011. Alcohol. 2017;52(1):119–25.
    1. Curran GM, Sullivan G, Williams K, et al. Emergency department use of persons with comorbid psychiatric and substance abuse disorders. Ann Emerg Med. 2003;41(5):659–67.
    1. Althaus F, Paroz S, Hugli O, et al. Effectiveness of interventions targeting frequent users of emergency departments: a systematic review. Ann Emerg Med. 2011;58(1):41–52.e42.

Source: PubMed

3
購読する