325 Prevalence of alcohol consumption in emergency presentations (PACE): biomarkers ethanol and phosphatidylethanol. (20th November 2022)

• Record Type: Journal Article
• Authors: Cameron, Cate; Vuong, Kim; Manzanero, Silvia; Ungerer, Jacobus; Mitchell, Gary; McWhinney, Brett; Zournazi, Anna; Vallmuur, Kirsten; Warren, Jacelle; McCreanor, Victoria; Howell, Tegwen
• Is Part Of: Injury prevention. Volume 28(2022)Supplement 2
• Page Start: A48
• Page End: A49
• Publication Date: 2022-11-20
• Subjects: Children's accidents -- Prevention -- Periodicals; Accidents -- Prevention -- Periodicals; 617.1
• DOI: 10.1136/injuryprev-2022-safety2022.146
• Languages: English
• ISSNs: 1353-8047

Abstract

Abstract : Background: There is a need for valid and reliable data on alcohol use in patients presenting to the Emergency Department (ED) to provide a more complete picture of the risk factors and inform targeted public health interventions and surveillance. Aims: This research aimed to test the ethical and practical processes required to conduct a prevalence study of alcohol consumption using a novel approach by using blood samples collected during routine care in ED presentations with two biomarkers, blood ethanol and phosphatidylethanol (PEth). Methods: This prevalence study involved the secondary use of routinely collected blood samples from patients presenting to the Royal Brisbane and Women's Hospital ED. Samples were tested for acute and medium-term alcohol intake using ethanol and PEth, over one collection period of 10 days. Ethanol is a biomarker of recent acute alcohol consumption, whereas PEth is biomarker for alcohol exposure during the previous 2–4 weeks. Results: A total of 1, 160 blood samples were intercepted and stored, between 22 January and 1 February 2021, including the Australia Day long weekend. The overall prevalence for blood ethanol was 9.3% (95%CI 7.8%-11.1%) in the total cohort, 5.3% for general medical presentations, increasing four-fold to 22.2% for injury presentations. The prevalence of PEth positive samples in the total cohort was 32.5% (95%CI 29.9%-35.3%), and 41.4% for injury presentations. There were 263 (25.3%) cases that tested negative for blood ethanol but positive for PEth concentrations indicative of significant to heavy alcohol use. Conclusion: This novel surveillance approach demonstrates that using blood ethanol tests in isolation significantly underestimates the prevalence of medium-term alcohol consumption in ED presentations. Performing periodic objective measurement of both acute and medium-term alcohol consumption accurately and objectively in ED presentations, would be valuable for informing targeted public health prevention and control strategies.