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Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication
  1. J Vardy1,
  2. T Keliher2,
  3. J Fisher3,
  4. F Ritchie2,
  5. C Bell2,
  6. M Chekroud4,
  7. F Clarey2,
  8. L Blackwood2,
  9. L Barry2,
  10. E Paton2,
  11. A Clark2,
  12. R Connelly2
  1. 1Emergency Department, Wishaw General Hospital, Wishaw, UK
  2. 2Emergency Department, Glasgow Royal Infirmary, Glasgow, UK
  3. 3ICU Department, Glasgow Royal Infirmary, Glasgow, UK
  4. 4Emergency Department, Hairmyres Hospital, East Kilbride, UK
  1. Correspondence to Dr J Vardy; jennifer.vardy{at}lanarkshire.scot.nhs.uk

Abstract

Objectives Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption.

Setting ED of a UK tertiary referral hospital.

Participants All ED admissions occurring over 14 weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%).

Primary outcome measures Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician.

Secondary outcome measures Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria.

Results 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with ‘Severe’ or ‘Very Severe’ acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56 years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003).

Conclusions Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD.

  • ACCIDENT & EMERGENCY MEDICINE
  • EPIDEMIOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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