Crilly Julia, East Katie, Brown Josea, Zhang Ping, Byrnes Josh, Furyk Jeremy, Duncan Jill, Jones Leonie, Brown Nathan J, Green David, Rothwell Sean, Rosengren David
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Qld, Australia; and School of Nursing and Midwifery, Griffith University, Qld, Australia; and Menzies Health Institute Queensland, Griffith University, Qld, Australia.
Department of Emergency Medicine, Metro South Hospital and Health Service, Qld, Australia.
Aust Health Rev. 2022 Dec;46(6):701-709. doi: 10.1071/AH22161.
Objective The harmful use of alcohol is a global issue. This study aimed to describe and compare the profiles, emergency department (ED) clinical characteristics, and outcomes of alcohol-related ED presentations (ARPs) and non-alcohol-related ED presentations (NARPs). Methods A multi-site observational study of all presentations to four EDs between 4 April 2016 and 31 August 2017, was conducted. Routinely collected ED clinical, administrative and costings data were used. Classification of ARPs were prospectively recorded by clinicians. Analysis was performed at the presentation, rather than person level. Univariate tests were undertaken to compare demographics, ED clinical characteristics and outcomes between ARPs and NARPs. Results A total of 418 051 ED presentations occurred within the 17-month study period; 5% (n = 19 875) were ARPs. Presentations made by people classified as ARPs were younger, more likely to be male, present on weekends or at night, and arrive by ambulance or police compared to NARPs. Compared with NARPs, ARPs had a longer median ED length of stay of over 20 min (95% CI 18-22, median 196 min vs 177 min, P < 0.001), a 5.5% (95% CI 4.9-5.3) lower admission rate (36% vs 42%, P < 0.001), and a AUD69 (95% CI 64-75) more expensive ED episode-of-care (AUD689 vs AUD622, P < 0.001). Conclusion Clinically meaningful differences were noted between alcohol-related and non-alcohol-related ED presentations. The higher cost of care for ARPs likely reflects their longer time in the ED. The healthcare and economic implications of incidents of alcohol-related harm extend beyond the ED, with ARPs having higher rates of ambulance and police use than NARPs.
目的 酒精的有害使用是一个全球性问题。本研究旨在描述和比较酒精相关急诊就诊（ARP）和非酒精相关急诊就诊（NARP）的特征、急诊科（ED）临床特征及结局。方法 对2016年4月4日至2017年8月31日期间四个急诊科的所有就诊情况进行了一项多中心观察性研究。使用了常规收集的急诊科临床、行政和成本数据。临床医生前瞻性记录ARP的分类。分析是在就诊层面而非个体层面进行的。采用单变量检验比较ARP和NARP之间的人口统计学、ED临床特征及结局。结果 在17个月的研究期间共发生了418051次ED就诊；5%（n = 19875）为ARP。与NARP相比，被归类为ARP的就诊者更年轻，男性比例更高，多在周末或夜间就诊，且更有可能通过救护车或警察送来。与NARP相比，ARP的急诊中位住院时间长超过20分钟（95%CI 18 - 22，中位数196分钟对177分钟，P < 0.001），入院率低5.5%（95%CI 4.9 - 5.3）（36%对42%，P < 0.001），且每次急诊护理费用贵69澳元（95%CI 64 - 75）（689澳元对6
