An examination of the characteristics of different measures of alcohol related attendance in adults presenting to emergency departments

There is limited analysis of characteristics for different measures of alcohol misuse in

attendees of Emergency Departments (ED). We explored the extent to which different

measures identified the same or different alcohol related attenders, and characteristics of

attendees that were predictive of alcohol misuse.

A 24-hour national survey of alcohol-related attendances was conducted in 32 randomly

selected EDs in England. Researchers administered a questionnaire, which included the Fast

Alcohol Screening Test (FAST) and obtained a breath alcohol sample from eligible attendees.

61% (n=1,083) of eligible attendees consented to participate. Four measures were

dichotomized as positive or negative for alcohol misuse: Self-reported alcohol-related

attendance; FAST score >3; ?80mg/100ml Blood Alcohol Concentration (BAC) and having at

least one alcohol binge in the last week (consumption of 6 (women)/8 (men) or more drinks

on one or more days). Statistical analysis included chi-squared tests and stepwise backward

selection logistic regression models using Stata 11.

46.7% of attendees were positive on one or more of the measures and 9.5% being positive on

all four measures. Of those positive, FAST identified 79.8% of those positive, Binge in the last

week, 74.9%, Self report, 24.1% and BAC >=80mg/100ml, 20.4% respectively. Being younger,

single, not an owner occupier, suffered an assault, mental health problem, physical injury,

involved in a violent incident, incident where a weapon was used, being injured and having

the last drink in a public house were significantly associated with all measures. Regression

analysis identified 19 separate variables were predictive of alcohol related attendance across

the measures. No single variable was common in being predictive of alcohol related

attendance. Being involved in a incident involving a weapon and attending because of mental

health issues were predictive of being FAST positive, intoxicated and binge in the last week.

Location of the incident being a public house was predictive of self-reported alcohol related

attendance, intoxication and binge in the last week.

There is considerable overlap in the characteristics that are associated with different

measures of alcohol related attendance. Logistic regression was predictive of different

characteristics for each measure. These findings suggest that multidimensional measures

provide the most comprehensive means of identifying of alcohol misuse in ED.