A comparison of methods to identify alcohol involvement in youth injury-related emergency department presentation data

Introduction and aims: The study aims to compare methods for identifying alcohol involvement in injury-related emergency department (ED) presentation in Queensland youth, and explore alcohol terminology used in triage text.

Design and methods: ED Information System data were provided for patients aged 12-24 years with an injury-related diagnosis code for a 5-year period 2006-2010 presenting to a Queensland ED (n=348,895). Three approaches were used to estimate alcohol involvement: (i) analysis of coded data; (ii) mining of triage text; and (iii) estimation using an adaptation of alcohol attributable fractions.

Results: Around 6.4% of these injury presentations overall had some documentation of alcohol involvement, with higher proportions of alcohol involvement documented for 18 to 24-year-olds, females, indigenous youth, where presentations occurred on a Saturday or Sunday, and where presentations occurred between midnight and 5 am. The most common alcohol terms identified for all subgroups were generic alcohol terms (e.g. ethanol or alcohol), with almost half of the cases where alcohol involvement was documented having a generic alcohol term recorded in the triage text.

Discussion and conclusions: ED data are useful sources of information for identification of high-risk sub-groups to target intervention opportunities, though it is not a reliable source of data for incidence or trend estimation in its current unstandardised form. Improving the accuracy and consistency of identification, documenting and coding of alcohol involvement at the point of data capture in the ED is the most desirable long-term approach to produce a more solid evidence base to support policy and practice in this field.