#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Emergency Department visits due to intoxications in a Dutch university hospital: Occurrence, characteristics and health care costs


Autoři: C. Verheij aff001;  P. P. M. Rood aff001;  C. K. Deelstra aff001;  M. L. L. Levendag aff001;  B. C. P. Koch aff002;  S. Polinder aff003;  S. C. E. Schuit aff004;  J. A. Haagsma aff001
Působiště autorů: Department of Emergency Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aff001;  Department of Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aff002;  Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands aff003;  Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands aff004
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226029

Souhrn

Background

Intoxications with alcohol and drugs are common in the Emergency Department. This study aimed to describe the occurrence and characteristics of intoxications (alcohol, Drugs of Abuse (DOA), pharmaceutical and chemical) presented to the Emergency Department and the health care costs of these intoxications.

Methods

This was a retrospective medical record study of all patients (≥ 16 years) who presented to the Emergency Department of an inner-city academic hospital in the Netherlands due to single or multiple intoxication(s) as the primary or secondary reason in the year 2016. An intoxication was reported as present if the attending physician described the intoxication in the patient’s medical record.

Results

A total of 783 patients were included, accounting for 3.2% of the adult Emergency Department population (age ≥ 16 year). In 30% more than one substance was used. Intoxications with alcohol, Drugs of Abuse and pharmaceuticals was reported in respectively 62%, 29% and 21% of the intoxicated patients. The mean costs per patient presenting with an intoxication to the Emergency Department was € 1,490. The mean costs per patient were highest for pharmaceutical intoxications (€ 2,980), followed by Drugs of Abuse (€ 1,140) and alcohol (€ 1,070).

Conclusions

Intoxications among patients aged 16 years and older are frequently seen at the Emergency Department and are frequently caused by multiple substances. Alcohol is the most common intoxication. Substantial healthcare costs are involved. Therefore, this study suggests that further research into hazardous alcohol consumption and DOA abuse is warranted.

Klíčová slova:

Alcohol consumption – Alcohols – Critical care and emergency medicine – Drug abuse – Hospitals – Intensive care units – Intoxication – NSAIDs


Zdroje

1. Vermes A, Roelofsen EE, Sabadi G, van den Berg B, de Quelerij M, Vulto AG. Intoxication with therapeutic and illicit drug substances and hospital admission to a Dutch university hospital. Neth J Med. 2003;61(5):168–72. 12916543

2. Indig D, Copeland J, Conigrave KM, Arcuri A. Characteristics and comorbidity of drug and alcohol-related emergency department presentations detected by nursing triage text. Addiction. 2010;105(5):897–906. doi: 10.1111/j.1360-0443.2009.02857.x 20148784

3. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila). 2017 Dec;55(10):1072–1252.

4. Ambrosius RG, Vroegop MP, Jansman FG, Hoedemaekers CW, Aarnoutse RE, van der Wilt GJ, et al. Acute intoxication patients presenting to an emergency department in The Netherlands: admit or not? Prospective testing of two algorithms. Emerg Med J. 2012;29(6):467–72. doi: 10.1136/emj.2010.106500 21546510

5. Kowalenko T, Burgess B, Szpunar SM, Irvin-Babcock CB. Alcohol and trauma—in every age group. Am J Emerg Med. 2013;31(4):705–9. doi: 10.1016/j.ajem.2012.12.032 23380101

6. Verelst S, Moonen PJ, Desruelles D, Gillet JB. Emergency department visits due to alcohol intoxication: characteristics of patients and impact on the emergency room. Alcohol Alcohol. 2012;47(4):433–8. doi: 10.1093/alcalc/ags035 22493048

7. Newton A, Sarker SJ, Pahal GS, van den Bergh E, Young C. Impact of the new UK licensing law on emergency hospital attendances: a cohort study. Emerg Med J. 2007;24(8):532–4. doi: 10.1136/emj.2007.046094 17652670

8. Parkinson K, Newbury-Birch D, Phillipson A, Hindmarch P, Kaner E, Stamp E, et al. Prevalence of alcohol related attendance at an inner city emergency department and its impact: a dual prospective and retrospective cohort study. Emerg Med J. 2016;33(3):187–93. doi: 10.1136/emermed-2014-204581 26698364

9. Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury. Rood PP, Haagsma JA, M Boersma S, Tancica A, Van Lieshout EM, Mulligan T, Van De Mheen D, Van Beeck EF, Patka P. Eur J Emerg Med. 2016 Apr;23(2):147–54. doi: 10.1097/MEJ.0000000000000186 25093895

10. Mullins PM, Mazer-Amirshahi M, Pines JM. Alcohol-Related Visits to US Emergency Departments, 2001–2011. Alcohol Alcohol. 2017;52(1):119–25. doi: 10.1093/alcalc/agw074 27998923

11. Cherpitel CJ, Ye Y. Trends in alcohol- and drug-related emergency department and primary care visits: data from four U.S. national surveys (1995–2010). J Stud Alcohol Drugs. 2012 May;73(3):454–8. doi: 10.15288/jsad.2012.73.454 22456250

12. Crane EH. Highlights of the 2011 Drug Abuse Warning Network (DAWN) Findings on Drug-Related Emergency Department Visits. The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013.

13. Wood DM, Greene SL, Dargan PI. Five-year trends in self-reported recreational drugs associated with presentation to a UK emergency department with suspected drug-related toxicity. Eur J Emerg Med. 2013 Aug;20(4):263–7. doi: 10.1097/MEJ.0b013e3283573115 22850087

14. Bush DM. Emergency Department Visits Involving Nonmedical Use of the Anti-anxiety Medication Alprazolam. The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US). 2013.

15. Maughan BC, Bachhuber MA, Mitra N, Starrels JL. Prescription monitoring programs and emergency department visits involving opioids, 2004–2011. Drug Alcohol Depend. 2015;156:282–8. doi: 10.1016/j.drugalcdep.2015.09.024 26454836

16. Jann M, Kennedy WK, Lopez G. Benzodiazepines: a major component in unintentional prescription drug overdoses with opioid analgesics. J Pharm Pract. 2014;27(1):5–16. doi: 10.1177/0897190013515001 24436437

17. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1575–86. doi: 10.1016/S0140-6736(13)61611-6 23993280

18. Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T, et al. Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition. Lancet. 2016;387(10028):1672–85. doi: 10.1016/S0140-6736(15)00390-6 26454360

19. Egerton-Warburton D, Gosbell A, Wadsworth A, Moore K, Richardson DB, Fatovich DM. Perceptions of Australasian emergency department staff of the impact of alcohol-related presentations. Med J Aust. 2016;204(4):155. doi: 10.5694/mja15.00858 26937670

20. Pirmohamed M, Brown C, Owens L, Luke C, Gilmore IT, Breckenridge AM, et al. The burden of alcohol misuse on an inner-city general hospital. Qjm. 2000;93(5):291–5. doi: 10.1093/qjmed/93.5.291 10825405

21. Imlach Gunasekara F, Butler S, Cech T, Curtis E, Douglas M, Emmerson L, et al. How do intoxicated patients impact staff in the emergency department? An exploratory study. N Z Med J. 2011;124(1336):14–23. 21946740

22. World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical descriptions and diagnostic guidelines. Acute intoxication. WHO; 2005.

23. Hakkaart-van Roijen L, Van der Linden N, Bouwmans CAM, Kanters T, Tan SS. Costing manual: Methodology of costing research and reference prices for economic evaluations in healthcare. 2015.

24. Kanters TA, Bouwmans CAM, van der Linden N, Tan SS, Hakkaart-van Roijen L. Update of the Dutch manual for costing studies in health care. PLoS One. 2017 Nov 9;12(11):e0187477. doi: 10.1371/journal.pone.0187477 29121647

25. Statistics Netherlands. StatLine database. Retrieved from: https://opendata.cbs.nl/statline/#/CBS/nl/dataset/70072ned/table?dl=24235

26. Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I, et al. Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN). Clin Toxicol (Phila). 2015;53(9):893–900.

27. Sorge M, Weidhase L, Bernhard M, Gries A, Petros S. Self-poisoning in the acute care medicine 2005–2012. Anaesthesist. 2015;64(6):456–62. doi: 10.1007/s00101-015-0030-x 25951922

28. Woodruff SI, McCabe CT, Hohman M, Clapp JD, Shillington AM, Eisenberg K, et al. Characteristics of Cannabis-Only and Other Drug Users Who Visit the Emergency Department. Cannabis Cannabinoid Res. 2016;1(1):149–53. doi: 10.1089/can.2016.0012 27689138

29. Van Laar MW, van Gestel B, Cruts AAN, van der Pol PM, Ketelaars APM, Beenakkers EMT, et al. Nationale Drug Monitor, Jaarbericht 2017. Trimbos Instituut. Netherlands Institute of Mental Health Care and Addiction; 2018.

30. Government of the Netherlands. Topics Drugs. Retrieved from: https://www.government.nl/topics/drugs.

31. Vroegop MP, Franssen EJ, van der Voort PH, van den Berg TN, Langeweg RJ, Kramers C. The emergency care of cocaine intoxications. Neth J Med. 2009. Apr;67(4):122–6. Review. 19581655

32. Duineveld C, Vroegop M, Schouren L, Hoedemaekers A, Schouten J, Moret-Hartman M, et al. Acute intoxications: differences in management between six Dutch hospitals. Clin Toxicol (Phila). 2012 Feb;50(2):120–8.

33. Parkinson K, Newbury-Birch D, Phillipson A, Hindmarch P, Kaner E, Stamp E, et al. Prevalence of alcohol related attendance at an inner city emergency department and its impact: a dual prospective and retrospective cohort study. Emerg Med J. 2016;33(3):187–93. doi: 10.1136/emermed-2014-204581 26698364

34. Downes MA, Healy P, Page CB, Bryant JL, Isbister GK. Structured team approach to the agitated patient in the emergency department. Emerg Med Australas. 2009;21(3):196–202. doi: 10.1111/j.1742-6723.2009.01182.x 19527279

35. Hendrix L, Verelst S, Desruelles D, Gillet JB. Deliberate self-poisoning: characteristics of patients and impact on the emergency department of a large university hospital. Emerg Med J. 2013;30(1):e9. doi: 10.1136/emermed-2011-201033 22328636


Článek vyšel v časopise

PLOS One


2019 Číslo 12
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#