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Risk of death high in alcohol-related visits to ED, new study finds


One in 20 Ontarians who had 2 or more alcohol-related ED visits in a 12-month period, died within a year of last visit

The risk of death for people who end up in the Emergency Department (ED) because of alcohol use is high according to a new study by researchers at ICES and the Centre for Addiction and Mental Health (CAMH), and the more frequently a person visits the ED due to alcohol-related factors, the greater their mortality risk.

The study, published today in CMAJ, looked at the patient records of more than 25,000 Ontarians aged 16 or older with at least two ED visits for mental and behavioural disorders related to alcohol in a 12-month period from 2010 to 2016, to determine mortality at one year after the last visit. 

The study found 66 per cent of those studied had two ED visits, 22 per cent has three to four ED visits and 12 per cent had five or more visits. One in 20 Ontarians who had two or more alcohol-related ED visits in a 12-month period die within a year of their last ED visit. But the risk of death doubled for those who had 5 or more visits to the ED for alcohol-related reasons. 

“Our study shows a high mortality rate in relatively young, mostly urban, lower-income individuals with frequent alcohol-related ED visits. These visits should be seen as critical opportunities for intervention on a high-risk population to reduce avoidable mortality,” says Dr. Paul Kurdyak, senior author and scientist at ICES and CAMH.

The researchers found that the bulk of deaths in the group studied included accidental poisoning, suicide, and trauma, as well as diseases of the digestive system.

The study focuses on individuals with mental and behavioural disorders due to alcohol as the main reason for the ED visit, which likely underestimates the burden of frequent ED use related to alcohol, including both the medical complications of alcohol use, and other factors like motor vehicle crashes.

In Canada, hospitalizations for alcohol-related illnesses outnumber those for heart attack. Alcohol-related injuries cost Canadians approximately $14.6 billion annually, with $3.3 billion in healthcare costs. The 2016 Global Burden of Disease Study found that alcohol was the single greatest risk factor for ill health worldwide in people aged 15-49. 

The researchers add that promising strategies include screening, brief intervention, treatment referrals, managed alcohol programs, and case management. The recent development of rapid access to addiction medicine (RAAM) clinics have demonstrated a capacity to both reduce substance use and ED visits may prove to also have an impact on mortality in this study’s population.

Author block: Jennifer Hulme, Hasan Sheikh, Edward Xie, Evgenia Gatov, Chenthila Nagamuthu and Paul Kurdyak.

The study “Mortality among Individuals who Frequently use Emergency Departments for Alcohol-Related Reasons: A Population-Based Cohort Study in Ontario,” was published in the CMAJ.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

For more information, please contact:

Deborah Creatura
Media Advisor, ICES
[email protected]


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