Predictors of clinical severity in subjects attending the Emergency Department for substance use: a ten-year cross-sectional study - 29/10/21
, Maria Pepe d, Lorenzo Moccia c, d, Isabella Panaccione e, Pierluigi Lanzotti d, Silvia Montanari d, Luigi Janiri c, d, Gabriele Sani c, d, Francesco Franceschi a, bAbstract |
Objective |
Substance-related referrals to the Emergency Department (ED) are rising. Multiple substance use is frequent, and psychiatric patients represent a high-risk population. Our study aimed at identifying risk factors for increased severity in ED attendances for substance use.
Methods |
We retrospectively evaluated consecutive patients attending the ED over ten years for substance-related problems, subdivided according to the triage code as having a life-threatening (LT), potentially life-threatening (P-LT), and non-life-threatening (N-LT) condition.
Results |
Substance/drug intake for deliberate self-harm was a risk factor for being classified as LT compared to both P-LT (OR = 6.357; p ≤ 0.001) and N-LT (OR = 28.19; p ≤ 0.001). Suicide attempts (OR = 4.435; p = 0.022) and multiple substance use (OR = 1.513; p = 0.009) resulted as risk factors for P-LT, compared to N-LT. Psychiatric diagnosis (OR = 1.942; p = 0.042) and multiple substance use (OR = 1.668; p = 0.047) were risk factors for being classified as LT rather than N-LT.
Conclusions |
In our sample, self-harming overdoses were the strongest risk factor for highest overall severity in a real-world setting. Psychiatric disorders and multiple substance use also increased the risk for greater severity at presentation. Substance use worsens patients' clinical picture and management, suggesting the need for consultation-liaison psychiatry services in emergency contexts and highlighting the role of EDs as key sites for identification and early intervention.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Referrals to Emergency Departments (ED) for substance use increased over the years. |
• | Patients with mental illness are at high-risk for substance-related ED accesses. |
• | Substance intake for deliberate self-harm predicted highest severity at presentation. |
• | Psychiatric diagnosis and multiple substance use were associated with greater severity. |
• | Consultation-liaison psychiatry is crucial to make ED key sites for early intervention. |
Keywords : Alcohol, Drugs, Psychiatric comorbidity, Multiple substance use, Triage, Suicidal behaviors
Plan
Vol 49
P. 287-290 - novembre 2021 Retour au numéro
Article précédent
- Cardiac arrest secondary to Covid19 pneumonia post full vaccination
- Eslam Mohamed, Peter Coyle, T. Suresh Kumar, Ashraf Molokhia, Tim Harris
- Gender differences in publication in emergency medicine journals
- Matthew E. Purdy, Brittnee N. Zmuda, Allyson M. Owens, Vivek Choudhary, Ryder C. Olsen, Julia O. Bader, Chase M. Donaldson
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?