Emergency Department visits due to intoxications in a Dutch university hospital: Occurrence, characteristics and health care costs

Abstract

BackgroundIntoxications with alcohol and drugs are common in the Emergency Department. This study aimed to describe the occurrence and characteristics of intoxications (alcohol, Drugs of Abuse (DOA), pharmaceutical and chemical) presented to the Emergency Department and the health care costs of these intoxications.MethodsThis was a retrospective medical record study of all patients (≥ 16 years) who presented to the Emergency Department of an inner-city academic hospital in the Netherlands due to single or multiple intoxication(s) as the primary or secondary reason in the year 2016. An intoxication was reported as present if the attending physician described the intoxication in the patient’s medical record.ResultsA total of 783 patients were included, accounting for 3.2% of the adult Emergency Department population (age ≥ 16 year). In 30% more than one substance was used. Intoxications with alcohol, Drugs of Abuse and pharmaceuticals was reported in respectively 62%, 29% and 21% of the intoxicated patients. The mean costs per patient presenting with an intoxication to the Emergency Department was € 1,490. The mean costs per patient were highest for pharmaceutical intoxications (€ 2,980), followed by Drugs of Abuse (€ 1,140) and alcohol (€ 1,070).ConclusionsIntoxications among patients aged 16 years and older are frequently seen at the Emergency Department and are frequently caused by multiple substances. Alcohol is the most common intoxication. Substantial healthcare costs are involved. Therefore, this study suggests that further research into hazardous alcohol consumption and DOA abuse is warranted.

Risk Management in First Aid for Acute Drug Intoxication

“…Drug abuse is an increasing phenomenon [13,14,22], also among the young people [5,24,27], with high involvement of the emergency department [17,21,25] and high hospitalization rates [28] and costs. [11] This growing "epidemic" is also spreading because of the misuse of prescribed medications, such as opioids and cannabinoids [15,16].…”

“…In addition to representing an essential tool for the first phase of care, the correct identification of intoxicated patients in ED has wide repercussions in terms of risk management [8,9]. The global evaluation of the patient and his pathology allows to set the best diagnostic-therapeutic path and avoid clinical errors in this category of patients [10,11]. We undertook a narrative review about the effectiveness role of a temporary observation unit (TOU) in ED to improve management of acute drugs intoxication.…”

Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow‐back

“…Hazardous alcohol use is a problem not only affecting the individual but also poses a burden on society, including the medical healthcare system (Verheij et al, 2019 ). In 2018, 9% of the adult Dutch population met the criteria for heavy drinking and 8% for excessive drinking (Trimbos Insitute, 2019 ).…”

“…A significant proportion of persons who sought medical care either had alcohol problems or consumed alcohol in such a way that it contributed substantially to their actual or potential medical problems (The Institute of Medicine [US] Committee, 1990 ). Also, alcohol‐related ED visits are increasing at a greater rate than overall ED visits and thereby represent a growing burden on hospital resources (Mullins et al, 2017 ; Verheij et al, 2019 ).…”

A comparative study of the effects of various locally-prepared agro-based carbons on the In vitro adsorption of cyanide using different activating agents

“…Chemical heterogeneity is associated to different functional groups at a surface (mainly oxygen) and to various surface contaminants. Both heterogeneities contribute to unique adsorption properties of activated carbons [3,4,5,6,7,8].…”