Survey of alcohol-related presentations to Australasian emergency departments

Egerton-Warburton, Diana; Gosbell, Andrew; Wadsworth, Angela; Fatovich, Daniel M; Richardson, Drew

doi:10.5694/mja14.00344

Cited by 53 publications

(77 citation statements)

References 197 publications

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“…It is known to underestimate the burden of alcohol on ED presentations 4, 6, 18. However, this does not exclude syndromic surveillance as a useful source of data for timely monitoring of acute alcohol harm trends at the state‐wide or local level.…”

Section: Discussionmentioning

confidence: 99%

“…However, systematically identifying alcohol as a contributing factor to injury‐related ED presentations in NSW is not possible 4. As such, ‘late‐night’ arrival to the ED is commonly used as a surrogate measure of alcohol‐related injuries 21, 35, 38.…”

Section: Discussionmentioning

confidence: 99%

“…In 2013, 26% of people aged 14 years or older consumed five or more standard drinks on a single drinking occasion at least once a month, placing them at risk of an alcohol‐related injury 2, 3. With an estimated 4–14% of emergency department (ED) presentations in Australia involving excessive alcohol consumption, depending on the time of the week, the ED remains a key setting in responding to alcohol harms 4, 5, 6. Such harms range from acute intoxication and poisoning to life‐threatening events due to intoxication (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…However, in Australia, this remains a challenge, as it is not mandatory to screen for or collect data on alcohol‐related ED presentations 4. Typically, the policy response relies on research from cross‐sectional or longitudinal survey‐based studies to estimate the prevalence of alcohol‐related ED presentations 4, 5, 7, 8. However, these study designs can be costly, are limited in their generalisability and are not timely enough to result in changes to service delivery.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

Whitlam

Dinh

Rodgers

et al. 2016

Drug and Alcohol Review

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Introduction and AimsAcute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.Design and MethodsWe selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.ResultsThe PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%.Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701]

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

Whitlam

Dinh

Rodgers

et al. 2016

Drug and Alcohol Review

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“…This survey found that one in seven presentations in Australia were alcoholrelated (14%); the rate for New Zealand was one in five (18%). 4 The second snapshot survey was conducted at 2.00 am on 6 December 2014. All EDs in Australia and New Zealand accredited by the Australasian College for Emergency Medicine (ACEM) for specialty training and non-accredited EDs that are part of the Emergency Medicine Education and Training (EMET) teaching network were invited to participate.…”

mentioning

confidence: 99%

A point‐prevalence survey of alcohol‐related presentations to Australasian emergency departments

Egerton-Warburton

Gosbell

Wadsworth

et al. 2018

Australian and New Zealand Journal of Public Health

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Effect of a Novel Brief Motivational Intervention for Alcohol-Intoxicated Young Adults in the Emergency Department

et al. 2022

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ImportanceHeavy drinking among young adults is a major public health concern. Brief motivational interventions in the emergency department have shown promising but inconsistent results.ObjectiveTo test whether young adults receiving a newly developed brief motivational intervention reduce their number of heavy drinking days and alcohol-related problems over 1 year compared with participants receiving brief advice.Design, Setting, and ParticipantsThis randomized clinical trial was conducted at an emergency department of a tertiary care university hospital in Lausanne, Switzerland. Recruitment ran from December 2016 to August 2019. Follow-up was conducted after 1, 3, 6, and 12 months. All adults aged 18 to 35 years presenting for any cause and presenting with alcohol intoxication were eligible (N = 2108); 1764 were excluded or refused participation. Follow-up rate was 79% at 12 months and 89% of participants provided follow-up data at least once and were included in the primary analyses. Statistical analysis was performed from September 2020 to January 2021.InterventionsThe novel intervention was based on motivational interviewing and comprised in-person discussion in the emergency department and up to 3 booster telephone calls. The control group received brief advice.Main Outcomes and MeasuresPrimary outcomes were the number of heavy drinking days (at least 60 g of ethanol) over the previous month and the total score on the Short Inventory of Problems (0-45, higher scores indicating more problems) over the previous 3 months. Hypotheses tested were formulated before data collection.ResultsThere were 344 young adults included (median [IQR] age: 23 [20-28] years; 84 women [24.4%]). Among the 306 participants providing at least 1 follow-up point, a statistically significant time × group interaction was observed (β = −0.03; 95% CI, −0.05 to 0.00; P = .02), and simple slopes indicated an increase of heavy drinking days over time in the control (β = 0.04; 95% CI, 0.02 to 0.05; P &lt; .001) but not in the intervention group (β = 0.01; 95% CI, −0.01 to 0.03; P = .24). There was no effect on the Short Inventory of Problems score (β = −0.01; 95% CI, −0.03 to 0.02; P = .71).Conclusions and RelevanceThis randomized clinical trial found that a brief motivational intervention implemented in the emergency department provided beneficial effects on heavy drinking, which accounts for a substantial portion of mortality and disease burden among young adults.Trial RegistrationISRCTN registry: 13832949

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Survey of alcohol-related presentations to Australasian emergency departments

Cited by 53 publications

References 197 publications

Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

A point‐prevalence survey of alcohol‐related presentations to Australasian emergency departments

Effect of a Novel Brief Motivational Intervention for Alcohol-Intoxicated Young Adults in the Emergency Department

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