Alcohol related to 29% of A&E cases early on Sunday mornings

The extent of Ireland's weekend drink problem has been highlighted in a new survey that shows 29% of Sunday early hours Emergency Department presentations are alcohol-related.

A first ever national study of alcohol-related admissions to hospital emergency departments analysed 3,194 presentations across all 29 EDs in the country, and found that alcohol-related presentations were more likely to be men, were more likely to arrive by ambulance and to then leave before being seen by a doctor, or leave against medical advice.

It also found those presenting with alcohol-related issues were less likely to be admitted to hospital.

In reviewing all records for the same four six-hour periods in every 24-hour ED in the country, researchers found that 189 (5.9% of the total) were alcohol related. However, more than half of that tally (57%) involved cases presenting in the early hours of Sunday morning.

And while alcohol related presentations represented just 1.2% of all ED presentations on Monday mornings, 29% of all ED presentations in the early hours of Sunday morning were drink-related.

According to the study:

Alcohol-related presentations are a significant burden on EDs and ambulance services, especially in the early hours of Sunday mornings.

The survey was coordinated to broadly represent times that are busy and quiet in EDs, with data gathered on Sunday, 11 December 2015, between midnight and 5:59am; Wednesday, 14 December 2015, between noon and 5:59pm; Friday, 6 January 2016, between 6pm and 11:59pm; and Monday, 16 January 2016, between 6am and 11:59am.

All 29 EDs, including the three paediatric-only EDs, were included and the alcohol-related presentations ranged from an 11-month-old accidental poisoning case to someone aged 85.

According to the study: "The busiest 6-hour period in terms of AR presentations was the early hours of Sunday morning when 108 (29%) of 372 presentations nationally had a reference to alcohol in the ED notes. Of the AR patients presenting early on Sunday, 63.2% (86 people) were categorised by clinical staff as intoxicated, compared with 20.6% on the study on Friday evening, 12.5% on Wednesday afternoon, and 3.7% on Monday morning."

It also found that in the same midnight Saturday to 6am Sunday slot, more than 68% of those attending EDs because of an alcohol-related issue went to hospital in an ambulance.

Yet 9% of AR presentations left before being assessed by a doctor compared with other 3.6% of other presentations and 7.9% of AR presentations discharged themselves against medical advice compared with 0.5% of those in the ED for a non-alcohol related issue. And while 26.5% of those in the ED with a non-drink related issue were admitted to hospital, 17.5% of those with an AR presentation were admitted.

The research, entitled 'Alcohol-related presentations to emergency departments in Ireland: a descriptive prevalence study', was published in the BMJ Open journal and was written by Brian McNicholl of the Emergency Department and Galway University Hospital, Deirdre Goggin of the Department of Public Health in the Health Service Executive in Galway, and Dr Diarmuid O’Donovan of the School of Medicine at NUI Galway.

Ms Goggin said more research was needed and that the Alcohol Bill currently progressing through the Oireachtas might also help.

She said anecdotally some people might have expected the rate of AR presentations on a Sunday morning to have been higher and added:

One of the major points out of the study is the numbers coming in via ambulance, which is a critical resource, and then leaving before they are seen.

Digital Desk

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