Baune Bernhard T, Mikolajczyk Rafael T, Reymann Gerhard, Duesterhaus Annette, Fleck Susanne, Kratz Hildegard, Sundermann Ulrike
Department of Psychiatry, University of Muenster, Germany.
BMC Health Serv Res. 2005 Nov 18;5:73. doi: 10.1186/1472-6963-5-73.
The purpose of the study was to identify and to profile alcohol-related attendances to emergency rooms (ERs) of 11 hospitals of various medical specialties covering a large urban population, to assess risk factors associated with short-stay cases, repeat attendances and higher degree of alcohol consumption and to estimate their impact on the alcohol-related burden at ERs.
A 6-months study was carried out to obtain clinical and administrative data on single and multiple attendances at ERs in 11 governmental acute hospitals in a large city in Germany. All alcohol-related attendances at ERs of study hospitals were eligible. A broad definition of alcohol-related attendances independently from alcohol diagnosis and various demographic, clinical and administrative measures were used. Odds ratios for the associations of these measures with duration of stay, repeat attendances and higher degrees of alcohol consumption were derived from multivariate binomial and multinomial logistic regression models.
1,748 patients with symptoms of alcohol consumption or withdrawal (inclusion rate 83.8%) yielded 2,372 attendances (3% of all medical admissions), and resulted in 12,629 inpatient-days. These patients accounted for 10.7 cases per 1,000 inhabitants. The average duration of inpatient stay was 10 days. 1,451 of all patients (83%) presented once, whereas the median of repeat attendances was three for the remaining 297 patients. Short-stay cases (<24 hours) were significantly linked with male gender, alcohol misuse, trauma (or suspicion of a trauma) and medical specialties. Increased levels of alcohol consumption at first attendance were significantly associated with repeat attendances in due course. In a multinomial logistic regression model higher degrees of alcohol consumption were significantly associated with male gender, trauma, short-stays, attendance outside regular working time, and with repeat attendances and self-discharge.
Apart from demographic factors, the alcohol-related clinical burden is largely determined by short-stay cases, repeat attendances and cases with higher levels of alcohol consumption at first attendance varying across medical specialties. These findings could be relevant for the planning of anti-alcoholic interventions at ERs.
本研究旨在识别并描述来自11家涵盖大量城市人口的不同医学专科医院急诊科与酒精相关的就诊情况，评估与短期住院病例、重复就诊以及更高酒精摄入量相关的风险因素，并估计它们对急诊科酒精相关负担的影响。
开展了一项为期6个月的研究，以获取德国一个大城市11家政府急症医院急诊科单次和多次就诊的临床及管理数据。研究医院急诊科所有与酒精相关的就诊情况均符合条件。采用了与酒精诊断无关的对与酒精相关就诊情况的宽泛定义以及各种人口统计学、临床和管理措施。这些措施与住院时间、重复就诊和更高酒精摄入量之间关联的比值比来自多变量二项式和多项逻辑回归模型。
1748例有酒精摄入或戒断症状的患者（纳入率83.8%）产生了2372次就诊（占所有医疗入院的3%），导致12629个住院日。这些患者相当于每1000名居民中有10.7例。住院平均时间为10天。所有患者中有1451例（83%）就诊一次，而其余297例患者重复就诊的中位数为3次。短期住院病例（<24小时）与男性、酒精滥用、创伤（或疑似创伤）以及医学专科显著相关。首次就诊时酒精摄入量增加与随后的重复就诊显著相关。在多变量逻辑回归模型中，更高的酒精摄入量与男性、创伤、短期住院、非正常工作时间就诊以及重复就诊和自行出院显著相关。
除人口统计学因素外，与酒精相关的临床负担在很大程度上由短期住院病例、重复就诊以及首次就诊时酒精摄入量较高的病例决定，且因医学专科而异。这些发现可能与急诊科抗酒精干预措施的规划相关。
