Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury

Pleunie P. M. Rood, Juanita A. Haagsma, Suzanne M. Boersma, Andrea Tancica, Esther M. M. Van Lieshout, Terrence Mulligan, Dike Van De Mheen, Ed F. Van Beeck, Peter Patka

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective
The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias.

Patients and methods
The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively.

Results
A total of 475 patients were included (response rate 87%). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19%. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95% confidence interval (CI) 1.54–5.40], of Dutch descent (native) (OR 2.26, 95% CI 1.24–4.13), unemployed or students (OR 1.77, 95% CI 1.03–3.04), and alcohol intoxication decreased with age (OR 0.98, 95% CI 0.96–0.99). Psychoactive medication was used by 7% of ED trauma patients; increasing age (OR 1.05, 95% CI 1.03–1.07) and living alone (OR 2.4, 95% CI 1.04–5.52) were risk factors. Illicit drugs were used by 4% of trauma patients. Overall, 27% of patients were under the influence of at least one psychoactive substance.

Conclusion
Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.
Original languageEnglish
Pages (from-to)147-154
JournalEuropean Journal of Emergency Medicine
Volume23
Issue number2
DOIs
Publication statusPublished - 2016
Externally publishedYes

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Alcohols
Odds Ratio
Wounds and Injuries
Confidence Intervals
Alcoholic Intoxication
Interviews

Keywords

  • prevalence, intoxication, alcohol, Emergency Department, trauma

Cite this

Rood, P. P. M., Haagsma, J. A., Boersma, S. M., Tancica, A., Van Lieshout, E. M. M., Mulligan, T., ... Patka, P. (2016). Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury. European Journal of Emergency Medicine, 23(2), 147-154. https://doi.org/10.1097/MEJ.0000000000000186
Rood, Pleunie P. M. ; Haagsma, Juanita A. ; Boersma, Suzanne M. ; Tancica, Andrea ; Van Lieshout, Esther M. M. ; Mulligan, Terrence ; Van De Mheen, Dike ; Van Beeck, Ed F. ; Patka, Peter. / Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury. In: European Journal of Emergency Medicine. 2016 ; Vol. 23, No. 2. pp. 147-154.
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title = "Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury",
abstract = "Objective The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias.Patients and methods The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively.Results A total of 475 patients were included (response rate 87{\%}). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19{\%}. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95{\%} confidence interval (CI) 1.54–5.40], of Dutch descent (native) (OR 2.26, 95{\%} CI 1.24–4.13), unemployed or students (OR 1.77, 95{\%} CI 1.03–3.04), and alcohol intoxication decreased with age (OR 0.98, 95{\%} CI 0.96–0.99). Psychoactive medication was used by 7{\%} of ED trauma patients; increasing age (OR 1.05, 95{\%} CI 1.03–1.07) and living alone (OR 2.4, 95{\%} CI 1.04–5.52) were risk factors. Illicit drugs were used by 4{\%} of trauma patients. Overall, 27{\%} of patients were under the influence of at least one psychoactive substance.Conclusion Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19{\%}). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.",
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author = "Rood, {Pleunie P. M.} and Haagsma, {Juanita A.} and Boersma, {Suzanne M.} and Andrea Tancica and {Van Lieshout}, {Esther M. M.} and Terrence Mulligan and {Van De Mheen}, Dike and {Van Beeck}, {Ed F.} and Peter Patka",
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Rood, PPM, Haagsma, JA, Boersma, SM, Tancica, A, Van Lieshout, EMM, Mulligan, T, Van De Mheen, D, Van Beeck, EF & Patka, P 2016, 'Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury', European Journal of Emergency Medicine, vol. 23, no. 2, pp. 147-154. https://doi.org/10.1097/MEJ.0000000000000186

Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury. / Rood, Pleunie P. M.; Haagsma, Juanita A.; Boersma, Suzanne M.; Tancica, Andrea; Van Lieshout, Esther M. M.; Mulligan, Terrence; Van De Mheen, Dike; Van Beeck, Ed F.; Patka, Peter.

In: European Journal of Emergency Medicine, Vol. 23, No. 2, 2016, p. 147-154.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury

AU - Rood, Pleunie P. M.

AU - Haagsma, Juanita A.

AU - Boersma, Suzanne M.

AU - Tancica, Andrea

AU - Van Lieshout, Esther M. M.

AU - Mulligan, Terrence

AU - Van De Mheen, Dike

AU - Van Beeck, Ed F.

AU - Patka, Peter

PY - 2016

Y1 - 2016

N2 - Objective The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias.Patients and methods The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively.Results A total of 475 patients were included (response rate 87%). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19%. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95% confidence interval (CI) 1.54–5.40], of Dutch descent (native) (OR 2.26, 95% CI 1.24–4.13), unemployed or students (OR 1.77, 95% CI 1.03–3.04), and alcohol intoxication decreased with age (OR 0.98, 95% CI 0.96–0.99). Psychoactive medication was used by 7% of ED trauma patients; increasing age (OR 1.05, 95% CI 1.03–1.07) and living alone (OR 2.4, 95% CI 1.04–5.52) were risk factors. Illicit drugs were used by 4% of trauma patients. Overall, 27% of patients were under the influence of at least one psychoactive substance.Conclusion Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.

AB - Objective The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias.Patients and methods The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively.Results A total of 475 patients were included (response rate 87%). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19%. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95% confidence interval (CI) 1.54–5.40], of Dutch descent (native) (OR 2.26, 95% CI 1.24–4.13), unemployed or students (OR 1.77, 95% CI 1.03–3.04), and alcohol intoxication decreased with age (OR 0.98, 95% CI 0.96–0.99). Psychoactive medication was used by 7% of ED trauma patients; increasing age (OR 1.05, 95% CI 1.03–1.07) and living alone (OR 2.4, 95% CI 1.04–5.52) were risk factors. Illicit drugs were used by 4% of trauma patients. Overall, 27% of patients were under the influence of at least one psychoactive substance.Conclusion Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.

KW - prevalence, intoxication, alcohol, Emergency Department, trauma

U2 - 10.1097/MEJ.0000000000000186

DO - 10.1097/MEJ.0000000000000186

M3 - Article

VL - 23

SP - 147

EP - 154

JO - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

SN - 0969-9546

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ER -