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Mortality Rate High With Frequent Alcohol-Linked ED Visits

TUESDAY, Dec. 1, 2020 — Individuals with frequent emergency department visits for alcohol-related reasons have a high mortality rate, according to a study published online Nov. 23 in CMAJ, the journal of the Canadian Medical Association.

Jennifer Hulme, M.D., M.P.H., from the University Health Network in Toronto, and colleagues conducted a retrospective cohort study using linked health administrative data for 25,813 people aged 16 to 105 years in Ontario with at least two emergency department visits for mental or behavioral disorders due to alcohol within one year. The primary outcome was one-year mortality, and premature mortality was examined using years of potential life lost (YPLL).

The researchers found that the likelihood of having three or four visits or having five or more visits was increased for men, those aged 45 to 64 years, and those living in urban centers and lower-income neighborhoods. The all-cause one-year mortality rate was 5.4 percent, varying from 4.7 to 8.8 percent among those with two visits and five or more visits, respectively. Death attributed to external causes was most common. Patients with five or more visits had a higher adjusted mortality rate than those with two visits (adjusted hazard ratio, 1.38). This represented 30,607 YPLL among 25,298 people aged 16 to 74 years.

“Our study shows a high mortality rate in relatively young, mostly urban, lower-income individuals with frequent alcohol-related emergency department visits,” a coauthor said in a statement. “These visits should be seen as critical opportunities for intervention on a high-risk population to reduce avoidable mortality.”

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