Department of Emergency and Hospital Medicine, Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine Allentown, Pennsylvania.
Department of Internal Medicine, Lehigh Valley Hospital and Health Network/University of South Florida Morsani College of Medicine Allentown, Pennsylvania.
Clin Ther. 2018 Feb;40(2):197-203. doi: 10.1016/j.clinthera.2017.12.013. Epub 2018 Jan 12.
Substance use and misuse is prevalent in emergency department (ED) populations. While the prevalence of substance use and misuse is reported, sex-specific trends in ED populations have not been documented. We set out to determine the sex-specific prevalence of ED patient substance use during this current epidemic.
A retrospective electronic data abstraction tool, developed for quality-improvement purposes, was used to assess ED visits in 3 hospitals in northeastern Pennsylvania. All patients with ED diagnosis codes for substance use F10.000 through F 19.999 (excluding F17 codes for nicotine) were abstracted for network ED visits at all 3 hospitals. Data points included ED clinical enrollment site, primary substance used, sex, date of ED visit, disposition (including left without being seen, left against medical advice, discharged, admitted, and treatment in rehabilitation) for 18 months (January 1, 2016 through July 31, 2017). The categorical parameters of sex, clinical enrollment site, diagnosis, date of ED visit, and disposition status were summarized as a proportion of the subject group. Time series analysis was used to assess trends in substance use and misuse visits by patient sex.
A total of 10,511 patients presented to the EDs during the study time period with a final diagnosis of a substance use-related reason and were included in the analysis. The mean age for these patients was 43.6 (SD 16.4) years, and the majority was male (65.6%, n = 6900). The most common substance in the final diagnosis for the ED visit was alcohol (54.3%; 95% CI, 53.3-55.2), followed by opioids (19.2%; 95% CI, 18.4-19.9) and cannabis (14.4%; 95% CI, 13.7-15.0). Females tended to be younger than males (42.4 years vs 44.3 years; P < 0.001), and were more likely to be discharged after the ED visit than males (36.1% vs 32.3%; P < 0.001). When exploring differences in age by sex and substance, males with a final diagnosis including alcohol- and cannabis-related issues were older than females, whereas females diagnosed with opioid-related reasons were older than males (41.3 vs 38.9 years; P < 0.001).
There are sex-specific differences in prevalence of patients presenting with substance use in the ED setting.
物质使用和滥用在急诊科（ED）人群中很普遍。虽然已经报道了物质使用和滥用的流行情况，但 ED 人群中没有记录到性别特异性趋势。我们旨在确定当前流行期间 ED 患者物质使用的性别特异性患病率。
使用为质量改进目的开发的回顾性电子数据提取工具，评估宾夕法尼亚州东北部 3 家医院的网络 ED 就诊。所有 ED 诊断代码为物质使用 F10.000 至 F19.999（不包括尼古丁 F17 代码）的患者，均从所有 3 家医院的 ED 就诊中提取。数据点包括 ED 临床入组地点、主要使用物质、性别、ED 就诊日期、处置（包括未就诊、未遵医嘱离开、出院、入院和康复治疗），为期 18 个月（2016 年 1 月 1 日至 2017 年 7 月 31 日）。将性别、临床入组地点、诊断、ED 就诊日期和处置状态等分类参数作为研究对象的比例进行总结。时间序列分析用于评估按患者性别划分的物质使用和滥用就诊趋势。
在研究期间，共有 10511 名患者因物质使用相关原因就诊于 ED，并纳入分析。这些患者的平均年龄为 43.6（16.4）岁，其中大多数为男性（65.6%，n=6900）。ED 就诊的最终诊断中最常见的物质是酒精（54.3%；95%CI，53.3-55.2），其次是阿片类药物（19.2%；95%CI，18.4-19.9）和大麻（14.4%；95%CI，13.7-15.0）。女性的年龄比男性小（42.4 岁比 44.3 岁；P<0.001），就诊后出院的可能性也比男性高（36.1%比 32.3%；P<0.001）。当按性别和物质探索年龄差异时，最终诊断为酒精和大麻相关问题的男性比女性年龄大，而最终诊断为阿片类药物相关问题的女性比男性年龄大（41.3 岁比 38.9 岁；P<0.001）。
ED 环境中存在与物质使用相关的就诊患者的性别特异性差异。
