Alcohol and violence in the emergency department: a regional report from the WHO collaborative study on alcohol and injuries

Abstract

ResumenObjetivo. Determinar el riesgo relativo (RR) de lesiones no intencionales y relacionadas con la violencia, asociadas al consumo de alcohol en tres Servicios de Urgencia de América Latina (2001)(2002). Material y métodos. Se usó un diseño case-crossover en 447 pacientes de Argentina (A), 489 de Brasil (B) y 455 de México (M). Resultados. El 46% de los casos relacionados a la violencia consumieron alcohol (vs. 11.5% de los no-violentos). El riesgo de una lesión relacionada con la violencia se incrementó con el consumo, y tuvo una RM= 15.0, intervalo de confianza al 95% (IC= 5.8-39.1), pero correspondió a 4.2 (IC= 2.7-6.5) para las lesiones nointencionales. Conclusiones. Mayores cantidades de alcohol tienen consecuencias en el riesgo de desencadenar una lesión, especialmente en lesiones relacionadas con la violencia. Los estimadores del RR que se presentan pueden ser usados como nuevas fuentes para estimadores de la carga de la enfermedad asociada al consumo de alcohol.Palabras clave: intoxicación alcohólica; epidemiología; méto-dos; América Latina; servicio de urgencia AbstractObjective. To determine the relative risk (RR) of non-fatal unintentional and violence-related injury associated with alcohol consumption in three emergency departments in Latin America (2001)(2002). Material and Methods. Pairmatched case-crossover was used to obtain RR estimates for alcohol in non-fatal injuries among 447 patients in Argentina (A), 489 in Brazil (B) and 455 in Mexico (M). Intentional (violence) or unintentional (non-violence) injury status were the main outcomes Results. About 46% of violence-related cases involved alcohol (versus 11.5% for non-violence related cases). The risk of violence-related injury increased with drinking and had an OR= 15.0 (95% confidence interval (CI), 5.8-39.1), with an OR= 4.2 (CI= 2.7-6.5) for unintentional injuries. Conclusions. Increasing amounts of drinking may have pronounced consequences on the risk of triggering an injury, especially for a violence-related injury. The RR estimates provided here can be useful for new estimates on alcohol and the burden of disease.

Physical Injuries, Pain, and Psychological Trauma: Pathways to Disability

“…Results indicated that alcohol was a factor in 46% of violent injuries and 11.5% of non-violent injuries. The authors indicated that the risk of violence-related injury increased with drinking; higher levels of drinking were associated with a 15-fold in risk for violence-related injuries and a fourfold increase in risk for non-violent-related injuries (Borges et al 2008). Alcohol use is highly correlated with death due to self-harm; 70% of persons who completed suicide by hanging were identified as current drinkers (Chen et al 2005).…”

“…Fifty-nine percent of persons involved in collision fatalities, 37% of persons who suffered falls, and 74% of drowning victims were current drinkers (Chen et al 2005). Borges et al (2008) used data derived from the WHO Collaborative Study on Alcohol and Injuries to establish the contribution of alcohol use to traumatic injuries occurring in violent and non-violent contexts. Results indicated that alcohol was a factor in 46% of violent injuries and 11.5% of non-violent injuries.…”

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“…Patients who drink alcohol heavily and risk death from an accident are 2.8-8 times higher than that of the nondrinking population, including a fall in 16 times, 10 times in burns or fire, 2-3 times in work-related injuries. According to world statistics, more than 25.0% of deaths are due to drowning associated with alcohol 32,33 .…”

Indicadores de actividad durante cinco años en un servicio de urgencias de atención voluntaria de un hospital psiquiátrico mexicano

“…17 Algunos servicios de urgencias de hospitales generales mexicanos han participado en estudios multicéntricos, los cuales han descrito la prevalencia de los trastornos mentales en población usuaria de servicios de urgencias de hospitales generales. [18][19][20] Aunque estos estudios son muy valiosos, los resultados obtenidos a partir de servicios de urgencias de hospitales generales no pueden interpretarse igual que en los servicios de urgencias de hospitales psiquiátricos, ya que la percepción de la enfermedad mental es completamente diferente en ambos tipos de hospital entre pacientes, familiares y proveedores de servicios de salud. 21,22 Para cuantificar la utilización de un servicio de salud, incluyendo un servicio de urgencias, el método más utilizado es con base en indicadores, que en el área de la salud pueden ser de dos tipos: de actividad y de calidad.…”