Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review

Lau, Georgina; Ang, Jia Ying; Kim, Nayoung; Gabbe, Belinda; Mitra, Biswadev; Dietze, Paul; Reeder, Sandra; Beck, Ben

doi:10.1136/injuryprev-2021-044513

Cited by 9 publications

(9 citation statements)

References 66 publications

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“…An emerging theme from current literature pertaining to risk factors for injury has been the detection of other drugs, besides alcohol, and were not considered in the present study. 22 A clinical guideline of routine testing for blood alcohol resulted in a high proportion of the eligible population having BACs, but BAC data were still missing for 12% of cases.…”

Section: Discussionmentioning

confidence: 99%

Alcohol‐related trauma presentations among older teenagers

Mitra

Ball

Lau

et al. 2022

Emerg Medicine Australasia

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Objective: The objectives of the present study were to report the proportion of older teenagers, including the subgroup operating a motor vehicle, presenting to an adult major trauma centre after injury with a positive blood alcohol concentration (BAC) over a 12-year period. Methods: This was a registry-based cohort study, including all patients aged 16-19 years presenting to an adult major trauma centre in Victoria, Australia from January 2008 to December 2019 and included in the trauma registry. A Poisson regression model was used to test for change in incidence of positive BAC associated trauma and summarised using incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Results: There were 1658 patients included for analysis and alcohol was detected in 368 (22.2%; 95% CI 20.2-24.3). Most alcohol positive presentations were on weekend days (n = 207; 56.3%) and most were males (n = 307). Over the 12-year period, there was a reduction in the incidence of older teenagers presenting with a positive BAC (IRR 0.95; 95% CI 0.93-0.98; P = 0.001). Among patients presenting after trauma in the setting of operating a motor vehicle (n = 545), alcohol was detected in 80 (14.7%) with no significant change in incidence of positive BAC (IRR 0.95; 95% CI 0.89-1.02; P = 0.17). Conclusions: A substantial proportion of older teenagers included in the registry had alcohol exposure prior to trauma. Despite a modest down-trending incidence, the need for continuing preventive measures is emphasised. In particular, preventive efforts should be targeted at male, older teenagers undertaking drinking activities on weekend days and driving motor vehicles.

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Section: Discussionmentioning

confidence: 99%

Alcohol‐related trauma presentations among older teenagers

Mitra

Ball

Lau

et al. 2022

Emerg Medicine Australasia

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“…Risk of bias was assessed using the Joanna Briggs Institute Checklist for Prevalence Studies, which is a validated tool designed to critically appraise the various study designs that can report on prevalence [30]. Detailed risk of bias assessment criteria have been published previously [25] and are available in Table S3, Supporting Information. Assessments were completed independently by two reviewers (authors GL and either JYA or NK).…”

Section: Methodsmentioning

confidence: 99%

“…The exclusion of studies that focused exclusively on specific injury causes is consistent with the methods of an existing systematic review that examined illicit drug use in emergency settings [3]. The protocol for the overarching review was prospectively registered to PROSPERO (CRD42020188746) and methods have previously been reported in corresponding papers [25,26].…”

Section: Introductionmentioning

confidence: 99%

Approaches and reporting of alcohol and other drug testing for injured patients in hospital‐based studies: A systematic review

Lau,

Ang,

Kim

et al. 2024

Drug and Alcohol Review

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IssueHospital alcohol and/or other drug (AOD) testing is important for identifying AOD‐related injuries; however, testing methods vary. This systematic review aimed to examine biological AOD testing methods from hospital‐based studies of injured patients and quantify what proportion reported key information on those testing methods.ApproachObservational studies published in English from 2010 onwards involving biological AOD testing for injured patients presenting to hospital were included. Studies examining single injury causes were excluded. Extracted data included concentration thresholds for AOD detection (e.g., lower limits of detection, author‐defined cut‐offs), test type (e.g., immunoassay, breathalyser) and approach (e.g., routine, clinical discretion), timing of testing, sample type and the proportion of injured cases tested for AODs.Key FindingsOf 83 included studies, 76 measured alcohol and 37 other drugs. Forty‐nine studies defined blood alcohol concentration thresholds (ranging from 0 to 0.1 g/100 mL). Seven studies defined concentration thresholds for other drugs. Testing approach was reported in 39/76 alcohol and 18/37 other drug studies. Sample type was commonly reported (alcohol: n = 69/76; other drugs: n = 28/37); alcohol was typically measured using blood (n = 60) and other drugs using urine (n = 20). Studies that reported the proportion of cases tested (alcohol: n = 53/76; other drugs: n = 28/37), reported that between 0% and 89% of cases were not tested for alcohol and 0% and 91% for other drugs. Timing of testing was often unreported (alcohol: n = 61; other drugs: n = 30).Implications and ConclusionVariation in AOD testing methods alongside incomplete reporting of those methods limits data comparability and interpretation. Standardised reporting of testing methods will assist AOD‐related injury surveillance and prevention.

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“…Specifically, the current paper reports on the subset of papers from the larger review that measured substance prevalence in violence-related injuries. The protocol for the larger review was prospectively registered to PROSPERO (CRD42020188746) and the methods have previously been reported in a corresponding paper (Lau et al, 2022).…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Alcohol and Other Drug Use in Patients Presenting to Hospital for Violence-Related Injuries: A Systematic Review

Lau

Ang

Kim

et al. 2023

Trauma, Violence, & Abuse

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Substance use is a risk factor for being both a perpetrator and a victim of violence. The aim of this systematic review was to report the prevalence of acute pre-injury substance use in patients with violence-related injuries. Systematic searches were used to identify observational studies that included patients aged ≥15 years presenting to hospital after violence-related injuries and used objective toxicology measures to report prevalence of acute pre-injury substance use. Studies were grouped based on injury cause (any violence-related, assault, firearm, and other penetrating injuries including stab and incised wounds) and substance type (any substance, alcohol only, drugs other than alcohol only), and they were summarized using narrative synthesis and meta-analyses. This review included 28 studies. Alcohol was detected in 13%–66% of any violence-related injuries (five studies), 4%–71% of assaults (13 studies), 21%–45% of firearm injuries (six studies; pooled estimate = 41%, 95% CI: 40%–42%, n = 9,190), and 9%–66% of other penetrating injuries (nine studies; pooled estimate = 60%, 95% CI: 56%–64%, n = 6,950). Drugs other than alcohol were detected in 37% of any violence-related injuries (one study), 39% of firearm injuries (one study), 7%–49% of assaults (five studies), and 5%–66% of penetrating injuries (three studies). The prevalence of any substance varied across injury categories: any violence-related injuries = 76%–77% (three studies), assaults = 40%–73% (six studies), firearms = n/a, other penetrating injuries = 26%–45% (four studies; pooled estimate = 30%, 95% CI: 24%–37%, n = 319).Overall, substance use was frequently detected in patients presenting to hospital for violence-related injuries. Quantification of substance use in violence-related injuries provides a benchmark for harm reduction and injury prevention strategies.

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Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review

Cited by 9 publications

References 66 publications

Alcohol‐related trauma presentations among older teenagers

Alcohol‐related trauma presentations among older teenagers

Approaches and reporting of alcohol and other drug testing for injured patients in hospital‐based studies: A systematic review

Prevalence of Alcohol and Other Drug Use in Patients Presenting to Hospital for Violence-Related Injuries: A Systematic Review

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