{"id":3214,"date":"2020-11-23T00:00:00","date_gmt":"2020-11-23T05:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/mortality-among-patients-with-frequent-emergency-department-use-for-alcohol-related-reasons-in-ontario-a-population-based-cohort-study\/"},"modified":"2023-06-14T19:50:03","modified_gmt":"2023-06-14T23:50:03","slug":"mortality-among-patients-with-frequent-emergency-department-use-for-alcohol-related-reasons-in-ontario-a-population-based-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/mortality-among-patients-with-frequent-emergency-department-use-for-alcohol-related-reasons-in-ontario-a-population-based-cohort-study\/","title":{"rendered":"Mortality among patients with frequent emergency department use for alcohol-related reasons in Ontario: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> &#x2014; Little is known about the risk of death among people who visit emergency departments frequently for alcohol-related reasons, including whether mortality risk increases with increasing frequency of visits. Our primary objective was to describe the sociodemographic and clinical characteristics of this high-risk population and examine their 1-year overall mortality, premature mortality and cause of death as a function of emergency department visit frequency in Ontario, Canada.<\/p>\n<p><strong>Methods<\/strong> &#x2014; We conducted a population-based retrospective cohort study using linked health administrative data (Jan. 1, 2010, to Dec. 31, 2016) in Ontario for people aged 16&#x2013;105 years who made at least 2 emergency department visits for mental or behavioural disorders due to alcohol within 1 year. We subdivided the cohort based on visit frequency (2, 3 or 4, or &#x2265; 5). The primary outcome was 1-year mortality, adjusted for age, sex, income, rural residence and presence of comorbidities. We examined premature mortality using years of potential life lost (YPLL).<\/p>\n<p><strong>Results<\/strong> &#x2014; Of the 25 813 people included in the cohort, 17 020 (65.9%) had 2 emergency department visits within 1 year, 5704 (22.1%) had 3 or 4 visits, and 3089 (12.0%) had 5 or more visits. Males, people aged 45&#x2013;64 years, and those living in urban centres and lower-income neighbourhoods were more likely to have 3 or 4 visits, or 5 or more visits. The all-cause 1-year mortality rate was 5.4% overall, ranging from 4.7% among patients with 2 visits to 8.8% among those with 5 or more visits. Death due to external causes (e.g., suicide, accidents) was most common. The adjusted mortality rate was 38% higher for patients with 5 or more visits than for those with 2 visits (adjusted hazard ratio 1.38, 95% confidence interval 1.19&#x2013;1.59). Among 25 298 people aged 16&#x2013;74 years, this represented 30 607 YPLL.<\/p>\n<p><strong>Interpretation<\/strong> &#x2014; We observed a high mortality rate among relatively young, mostly urban, lower-income people with frequent emergency department visits for alcohol-related reasons. These visits are opportunities for intervention in a high-risk population to reduce a substantial mortality burden.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Little is known about the risk of death among people who visit emergency departments frequently for alcohol-related reasons, including whether mortality risk increases with increasing frequency of visits. Our primary objective was to describe the sociodemographic and clinical characteristics of this high-risk population and examine their 1-year overall mortality, premature mortality and cause [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-3214","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Hulme J, Sheikh H, Xie E, Gatov E, Nagamuthu C, Kurdyak P. <em>CMAJ<\/em>. 2020; 23(19):E1522-31. Epub 2020 Nov 23.","source_url":"https:\/\/www.cmaj.ca\/content\/192\/47\/E1522","ices_scientist":[1152],"site":[6733],"research_program":[6744],"news_release":[7517],"journal_article":[],"atlas":[],"research_report":[],"infographic":[9370],"video":[],"downloads":null,"links":null,"sitecore_item_id":"9BD27C7C-5464-4861-8F53-920013A16F11","sitecore_item_name":"Mortality-among-patients-with-frequent-emergency-department-use-for-alcohol-related-reasons","sitecore_field_values":"{\n  \"Title\": \"Mortality among patients with frequent emergency department use for alcohol-related reasons in Ontario: a population-based cohort study\",\n  \"Short title\": \"Mortality among patients with frequent\",\n  \"Summary\": \"The researchers observed a high mortality rate among relatively young, mostly urban, lower-income people with frequent emergency department visits for alcohol-related reasons.\",\n  \"Citation\": \"<p>Hulme J, Sheikh H, Xie E, Gatov E, Nagamuthu C, Kurdyak P. <em>CMAJ<\/em>. 2020; 23(19):E1522-31. Epub 2020 Nov 23. DOI: <a href=\"https:\/\/doi.org\/10.1503\/cmaj.191730\" title=\"opens external link\">https:\/\/doi.org\/10.1503\/cmaj.191730<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Background<\/strong> &mdash; Little is known about the risk of death among people who visit emergency departments frequently for alcohol-related reasons, including whether mortality risk increases with increasing frequency of visits. Our primary objective was to describe the sociodemographic and clinical characteristics of this high-risk population and examine their 1-year overall mortality, premature mortality and cause of death as a function of emergency department visit frequency in Ontario, Canada.<\/p>n<p><strong>Methods<\/strong> &mdash; We conducted a population-based retrospective cohort study using linked health administrative data (Jan. 1, 2010, to Dec. 31, 2016) in Ontario for people aged 16&ndash;105 years who made at least 2 emergency department visits for mental or behavioural disorders due to alcohol within 1 year. We subdivided the cohort based on visit frequency (2, 3 or 4, or &ge; 5). The primary outcome was 1-year mortality, adjusted for age, sex, income, rural residence and presence of comorbidities. We examined premature mortality using years of potential life lost (YPLL).<\/p>n<p><strong>Results<\/strong> &mdash; Of the 25 813 people included in the cohort, 17 020 (65.9%) had 2 emergency department visits within 1 year, 5704 (22.1%) had 3 or 4 visits, and 3089 (12.0%) had 5 or more visits. Males, people aged 45&ndash;64 years, and those living in urban centres and lower-income neighbourhoods were more likely to have 3 or 4 visits, or 5 or more visits. The all-cause 1-year mortality rate was 5.4% overall, ranging from 4.7% among patients with 2 visits to 8.8% among those with 5 or more visits. Death due to external causes (e.g., suicide, accidents) was most common. The adjusted mortality rate was 38% higher for patients with 5 or more visits than for those with 2 visits (adjusted hazard ratio 1.38, 95% confidence interval 1.19&ndash;1.59). Among 25 298 people aged 16&ndash;74 years, this represented 30 607 YPLL.<\/p>n<p><strong>Interpretation<\/strong> &mdash; We observed a high mortality rate among relatively young, mostly urban, lower-income people with frequent emergency department visits for alcohol-related reasons. These visits are opportunities for intervention in a high-risk population to reduce a substantial mortality burden.<\/p>n<p><a href=\"https:\/\/www.cmaj.ca\/content\/192\/47\/E1522\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{DD981CF2-C2A6-457A-9917-A8DD64CCF7D6}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{B5C574DB-2952-4976-9299-A6F54F1757FA}\",\n  \"Posted Date\": \"20201123T000000\",\n  \"Show on Publications Landing Page\": \"1\",\n  \"In The News\": \"{019326E2-0321-44A6-9ACC-53457B010A39}\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2020\/November\/Mortality-among-patients-with-frequent-emergency-department-use-for-alcohol-related-reasons"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Mortality among patients with frequent emergency department use for alcohol-related reasons in Ontario: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; 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