Article Data

  • Views 2452
  • Dowloads 177

Original Research

Open Access Special Issue

The characteristics associated with alcohol co-ingestion in patients visited to the emergency department with deliberate self-poisoning: retrospective study

  • Hye Jin Kim1
  • Duk Hee Lee2

1Department of Emergency Medicine. Sanggye Paik Hospital. Inje University College of Medicine, Seoul, Republic of Korea

2Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

DOI: 10.22514/sv.2021.035 Vol.17,Issue 4,July 2021 pp.108-117

Submitted: 02 January 2021 Accepted: 01 February 2021

Published: 08 July 2021

*Corresponding Author(s): Duk Hee Lee E-mail: ewhain78@gmail.com

Abstract

Objective: The aim of this study was to investigate the characteristics associated with alcohol co-ingestion by measuring blood alcohol concentration in patients visited to the emergency department with deliberate self-poisoning. Also, it was to evaluate the accuracy of self-reported alcohol ingestion.

Methods: The initial assessment forms, medical records and laboratory tests of patients visited to the ED after DSP between March 2017 and June 2020 were retrospectively reviewed. Based on the patients’ BAC, two groups were formed: the non-alcohol group and the alcohol group.

Results: This study included 286 patients (56.6%, n = 162) in the non-alcohol group and 43.4% (n = 124) in the alcohol group. In multivariate logistic analysis, alcohol co-ingestion was independently associated with no history of psychiatric admission (Odds Ratio = 6.222, 95% Confidence Interval = 1.148-33.716, P = 0.034), lactate (mg/dL)(Odds Ratio = 1.961, 95% Confidence Interval = 1.274-3.019, P = 0.002), and C-reactive protein level (mg/dL) (Odds Ratio = 0.003, 95% Confidence Interval = 0.000-0.897, P = 0.046). The receiver operating characteristics analysis of lactate value for the association with alcohol co-ingestion showed a cutoff value of 1.45, with 88.1% sensitivity, 71.6%specificity, and an area under the curve of 0.845. There was no statistically significant difference in emergency department disposition between the two groups. Using the 261 subjects who completed the self-report of alcohol co-ingestion, self-report resulted in 77.6% sensitivity and 76.6% specificity for the assessment of alcohol co-ingestion. The positive and negative predictive values for self-reporting were 72.6% and 81.0%, respectively.

Conclusions: Alcohol co-ingestion was associated with no history of psychiatric ward admission, high lactate levels, and low C-reactive protein values in patients who visited the emergency department with deliberate self-poisoning. This study showed that self-reported alcohol co-ingestion was not a substitute for the blood alcohol concentration test.

Keywords

Alcohol drinking; Emergency medical service; Self-injurious behabior; Lactates; Self report


Cite and Share

Hye Jin Kim,Duk Hee Lee. The characteristics associated with alcohol co-ingestion in patients visited to the emergency department with deliberate self-poisoning: retrospective study. Signa Vitae. 2021. 17(4);108-117.

References

[1] Organization for Economic Co-operation and Development. Health status, mortality. 2018. Available at: https://data.oecd.org/healthstat/suicide-rates.htm (Accessed: 14 August 2018).

[2] Azizpour Y, Asadollahi K, Sayehmiri K, Kaikhavani S, Abangah G. Epidemiological survey of intentional poisoning suicide during 1993-2013 in Ilam Province, Iran. BMC Public Health. 2016; 16: 902.

[3] Ajdacic-Gross V, Weiss MG, Ring M, Hepp U, Bopp M, Gutzwiller F, et al. Methods of suicide: international suicide patterns derived from the who mortality database. Bulletin of the World Health Organization. 2008; 86: 726-732.

[4] Romero MP, Wintemute GJ. The epidemiology of firearm suicide in the United States. Journal of Urban Health. 2002; 79: 39-48.

[5] Choi D, Kim H, Kim C, Park S, Kim S, Cho Y, et al. Sociodemographic characteristics of the suicide attempters visiting emergency room. The Korean Journal of Psychopathology. 2000; 9: 36-49.

[6] Kang JH, Lee HN, Jin YH, Lee JB. A clinical analysis of acute drug intoxication in emergency department setting. Journal of the Korean Society of Emergency Medicine. 1999; 10: 431-440.

[7] Verstraete AG, Buylaert WA. Survey of patients with acute poisoning seen in the Emergency Department of the University Hospital of Gent between 1983 and 1990. European Journal of Emergency Medicine. 1995; 2: 217-223.

[8] Hawton K, Bergen H, Casey D, Simkin S, Palmer B, Cooper J, et al. Self-harm in England: a tale of three cities. Multicentre study of self-harm. Social Psychiatry and Psychiatric Epidemiology. 2007; 42: 513-521.

[9] Conner KR, Bagge CL, Goldston DB, Ilgen MA. Alcohol and suicidal behavior: what is known and what can be done. American Journal of Preventive Medicine. 2014; 47: S204-S208.

[10] Bagge CL, Sher KJ. Adolescent alcohol involvement and suicide attempts: toward the development of a conceptual framework. Clinical Psychology Review. 2008; 28: 1283-1296.

[11] Bagge CL, Conner KR, Reed L, Dawkins M, Murray K. Alcohol use to facilitate a suicide attempt: an event-based examination. Journal of Studies on Alcohol and Drugs. 2015; 76: 474-481.

[12] Woo SH, Lee WJ, Jeong WJ, Kyong YY, Choi SM. Blood alcohol concentration and self-reported alcohol ingestion in acute poisoned patients who visited an emergency department. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2013; 21: 24-29.

[13] Weathermon R, Crabb DW. Alcohol and medication interactions. Alcohol Research & Health. 1999; 23: 40-54.

[14] Fleming MF, Barry KL, Manwell LB, Johnson K, London R. Brief physician advice for problem alcohol drinkers. The Journal of the American Medical Association. 1997; 277: 1039-1045.

[15] O’Farrell TJ, Maisto SA. The utility of self-report and biological measures of alcohol consumption in alcoholism treatment outcome studies. Advances in Behaviour Research and Therapy. 1987; 9: 91-125.

[16] Sommers MS, Dyehouse JM, Howe SR, Lemmink J, Volz T, Manharth M. Validity of self-reported alcohol consumption in nondependent drinkers with unintentional injuries. Alcoholism: Clinical and Experimental Research. 2000; 24: 1406-1413.

[17] Pajoum A, Fahim F, Akhlaghdoust M, Zamani N, Amirfirooz Z, Dehdehasti M. Rhabdomyolysis and acute poisoning; A brief report. Emergency. 2018; 6: e56.

[18] Golaghaei A, Hassanian-Moghaddam H, Shadnia S, Zamani N, Amraei F. Potential prognostic roles of serum lactate and Creatine kinase levels in poisoned patients. BMC Emergency Medicine. 2020; 20: 32-36.

[19] MacDonald L, Kruse JA, Levy DB, Marulendra S, Sweeny PJ. Lactic acidosis and acute ethanol intoxication. American Journal of Emergency Medicine. 1994; 12: 32-35.

[20] Sawiniec J, Gnyp L, Lewandowska-Stanek H. C-reactive protein as a useful prognostic marker in acute poisoning. Przeglad Lekarski. 2004; 61: 356-358.

[21] Cherpitel CJ, Borges GLG, Wilcox HC. Acute alcohol use and suicidal behavior: a review of the literature. Alcoholism: Clinical and Experimental Research. 2004; 28: 18S-28S.

[22] Borges G, Rosovsky H. Suicide attempts and alcohol consumption in an emergency room sample. Journal of Studies on Alcohol. 1996; 57: 543-548.

[23] Branas CC, Richmond TS, Ten Have TR, Wiebe DJ. Acute alcohol consumption, alcohol outlets, and gun suicide. Substance Use & Misuse. 2011; 46: 1592-1603.

[24] Bagge CL, Lee HJ, Schumacher J, Gratz K, Krull J, Holloman G. Alcohol as an acute risk factor for suicide attempt: a case-crossover analysis. Journal of Studies on Alcohol and Drugs. 2013; 74: 552-558.

[25] Conner KR, Huguet N, Caetano R, Giesbrecht N, McFarland BH, Nolte KB, et al. Acute use of alcohol and methods of suicide in a US national sample. American Journal of Public Health. 2014; 104: 171-178.

[26] Lejoyeux M, Huet F, Claudon M, Fichelle A, Casalino E, Lequen V. Characteristics of suicide attempts preceded by alcohol consumption. Archives of Suicide Research. 2008; 12: 30-38.

[27] Suokas J, Lönnqvist J. Suicide attempts in which alcohol is involved: a special group in general hospital emergency rooms. Acta Psychiatrica Scandinavica. 1995; 91: 36-40.

[28] Bagge CL, Conner KR, Reed L, Dawkins M, Murray K. Alcohol use to facilitate a suicide attempt: an event-based examination. Journal of Studies on Alcohol and Drugs. 2015; 76: 474-481.

[29] Treno AJ, Gruenewald PJ, Johnson FW. Sample selection bias in the emergency room: an examination of the role of alcohol in injury. Addiction. 1998; 93: 113-129.

[30] Sommers MS, Dyehouse JM, Howe SR, Lemmink J, Volz T, Manharth M. Validity of self-reported alcohol consumption in nondependent drinkers with unintentional injuries. Alcoholism, Clinical and Experimental Research. 2000; 24: 1406-1413.

[31] Jones AW, Jönsson KA. Food-induced lowering of blood-ethanol profiles and increased rate of elimination immediately after a meal. Journal of Forensic Sciences. 1994; 39: 1084-1093.

[32] Jones AW, Sternebring B. Kinetics of ethanol and methanol in alcoholics during detoxification. Alcohol and Alcoholism. 1992; 27: 641-647.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top