Medical needs of emergency department patients presenting with acute alcohol and drug intoxication

Stang, Jamie; DeVries, Paige A.; Klein, Lauren R.; Cole, Jon B.; Martel, Marc L.; Reing, Mackenzie; Raiter, Abagail M.

doi:10.1016/j.ajem.2020.12.079

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Regarding Toxic, according to the ALC-10 classi cation criteria, it encompasses ALCs caused by ingestion or inhalation of toxic materials (alcohol, insecticides ingestion, or adverse drug reactions), regardless of intent. It is well known that depression and suicide increased in AC [31][32][33][34][35]. Based on the authors' experience in the ER, there has been an increase in binge drinking or drug administration associated with feelings of hopelessness or suicidal intentions after the onset of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Etiology and mortality of patients with altered level of consciousness in the emergency room: a multicenter analysis before and after the coronavirus disease 2019 outbreak

Kim,

Seo,

Park

et al. 2024

Preprint

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New-onset altered level of consciousness (ALC) is challenging in emergency rooms (ERs), requiring focused attention. The COVID-19 pandemic has impacted healthcare systems globally, influencing ER dynamics. This study compared ALC before (BC) and after (AC) the coronavirus disease 2019 outbreak, focusing on etiology, disposition, and outcomes. This was a retrospective, multicenter study of four university hospitals in charge of an area of about five million people in South Korea. All cases were reviewed within a consortium of board-certified faculties and compared between BC (February 2018 to January 2020) and AC (March 2021 to February 2023. We reviewed to find 17,913 patients who visited the ER due to ALC, of whom 7,988 and 9,925 were in BC and AC, respectively. The overall incidence of ALC in the ER was 3.1%, higher in AC (BC vs. AC, 2.5% vs. 3.7%, p < 0.001). The most common etiology was Metabolic cause (24.8%), followed by Systemic infection (18.0%). Intracranial etiologies accounted for 29.7% of the total. Hospitalization rate increased from BC to AC (54.5–59.3%, p < 0.001). The overall mortality was 16.2%, and 5.3% of the patients with ALC died in the ER. ALCs dut to cardiogenic and vascular etiology had the highest mortality (26.8%). This study marks the first investigation on ALC in the ER comparing BC and AC.

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Section: Discussionmentioning

confidence: 99%

Etiology and mortality of patients with altered level of consciousness in the emergency room: a multicenter analysis before and after the coronavirus disease 2019 outbreak

Kim,

Seo,

Park

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Given the high frequency of alcohol use among college students, intoxicated patients are often dismissed as being of low acuity. The potential for underestimating the likelihood of serious disease occurring among those with apparent simple alcohol intoxication may exist with it being not uncommon for physicians to obtain imaging studies and implement other therapeutic interventions based upon their clinical assessment [ 18 ]. At times, the presence of alcohol intoxication itself may be incorrectly assumed.…”

Section: Discussionmentioning

confidence: 99%

“…Between 11 p.m. and 7 a.m.,18.9% (66/350) of young adults with alcohol intoxication left before treatment completion compared to 5.9% (143/2,438) non-alcohol-intoxicated young adults (P < 0.01). Rates of those who left before treatment completion did not vary significantly among those with alcohol intoxication as a chief complaint who presented during 11 p.m. to 7 a.m. compared to other times (16.7%, 19/114; P = 0.67).…”

mentioning

confidence: 90%

Leaving Before Completion of Treatment Among Alcohol-Intoxicated, College-Aged Emergency Department Patients

Betten¹,

Trentham²,

Corser³

et al. 2023

Cureus

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Background Heavy alcohol use among college-aged students is common and may lead to Emergency Department (ED) visits. A review of alcohol-intoxicated presentations to a single ED was performed to characterize these encounters and identify factors associated with leaving before treatment completion. Methodology Electronic medical records were reviewed for patients aged 18 to 25 years over a nine-month study period who presented to a university-affiliated ED with isolated alcohol intoxication and were subsequently discharged or left before completion of treatment. The frequency and characteristics of these individuals were compared using chi-square analysis. A series of controlled logistic and multinomial regression models were conducted to examine the predictive significance of potentially confounding variables (age, gender, time and day of presentation, method of hospital arrival, and triage level) associated with premature ED departure and length of stay. Measured ethanol levels and vital sign abnormalities at the time of leaving the ED were identified. Results Four hundred sixty-four patients aged 18 to 25 years presented with isolated alcohol intoxication over the study period. A higher frequency of leaving without completion of treatment was noted in college-aged alcohol-intoxicated individuals compared to the general adult ED population (17.9% versus 3.5%; P < 0.01). Abnormal vital signs (10.5%) and elevated ethanol levels before ED departure when measured (85.2%) were not uncommon. Variables significantly associated with leaving before completion of treatment included arrival by means other than emergency medical service (EMS)/police, lower triage levels, and 11 p.m. to 7 a.m. hospital departure. Conclusions Based on these results, intoxicated college-aged individuals are at high risk for leaving EDs before care completion. The development of targeted protocols to minimize this occurrence and utilizing these ED encounters to consider addressing unhealthy drinking behaviors may be helpful.

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Soins en urgence et soins prolongés en addictologie

Jullian,

Franchitto

2023

Les Addictions

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Medical needs of emergency department patients presenting with acute alcohol and drug intoxication

Cited by 7 publications

References 20 publications

Etiology and mortality of patients with altered level of consciousness in the emergency room: a multicenter analysis before and after the coronavirus disease 2019 outbreak

Etiology and mortality of patients with altered level of consciousness in the emergency room: a multicenter analysis before and after the coronavirus disease 2019 outbreak

Leaving Before Completion of Treatment Among Alcohol-Intoxicated, College-Aged Emergency Department Patients

Soins en urgence et soins prolongés en addictologie

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