Epidemiology of alcohol-related emergency department visits

G Li, P M Keyl, R Rothman, A Chanmugam, G D Kelen
Academic Emergency Medicine 1998, 5 (8): 788-95

OBJECTIVE: To examine the population and geographic patterns, patient characteristics, and clinical presentations and outcomes of alcohol-related ED visits at a national level.

METHODS: Cross-sectional data on a probability sample of 21,886 ED visits from the 1995 National Hospital Ambulatory Medical Care Survey were analyzed with consideration of the individual patient visit weight. The annual number and rates of alcohol-related ED visits were computed based on weighted analysis in relation to demographic characteristics and geographic region. Specific variables of alcohol-related ED visits examined included demographic and medical characteristics, patient-reported reasons for visit, and physicians' principal diagnoses.

RESULTS: Of the 96.5 million ED visits in 1995, an estimated 2.6 million (2.7%) were related to alcohol abuse. The overall annual rate of alcohol-related ED visits was 10.0 visits per 1,000 population [95% confidence interval (CI) 8.7-11.3]. Higher rates were found for men (14.7 per 1,000, 95% CI 12.5-16.9), adults aged 25 to 44 years (17.8 per 1,000, 95% CI 15.0-20.6), blacks (18.1 per 1,000, 95% CI 14.0-22.1), and residents living in the northeast region (15.2 per 1,000, 95% CI 12.1-18.2). Patients whose visits were alcohol-related were more likely than other patients to be uninsured, smokers, or depressive. Alcohol-related ED visits were 1.6 times as likely as other visits to be injury-related, and 1.8 times as likely to be rated as "urgent" or "emergent." The leading principal reasons for alcohol-related ED visits were complaints of pain, injury, and drinking problems. Alcohol abuse/dependence was the principal diagnosis for 20% of the alcohol-related visits.

CONCLUSION: Alcohol abuse poses a major burden on the emergency medical care system. The age, gender, and geographic characteristics of alcohol-related ED visits are consistent with drinking patterns in the general population.

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