An 11-year analysis of alcohol-related emergency department presentations by young people, from an EU hospital setting

Background

Alcohol-related harms are experienced across the developmental lifespan. In young people the neurotoxic effects of alcohol can cause permanent brain changes, increased risk of later alcohol dependence and associated memory and learning deficits. Acute alcohol-related harms places increasing demands on emergency departments and hospital resources to respond to a range of negative consequences wholly or partially attributable to risky patterns of alcohol consumption by young people. The aim of this study was to estimate the scale and nature of alcohol-related harms to children and young people presenting to two emergency departments with acute conditions, wholly or partially attributable to their personal consumption of alcohol for an 11-year period.

Methods

The research design was retrospective with a concurrent dominant quantitative approach with a qualitative aspect nested within. Filters were applied to the search of the hospital data management system, using key alcohol search words and terms. Anonymized secondary data was extracted from the relevant data capture fields, spanning both pediatric and adult emergency department presentations of young people aged 12–18-years old, for an 11-year period (2009-2019). Descriptive and basic inferential analysis, alongside content analysis were completed. Ethical approval was granted on the 3rd March 2020 by Trinity College Dublin. 

Results

A total of 1,325 young people aged between 12-18 years presented at two emergency departments between 2009-2019, having personally consumed alcohol. Almost two thirds were brought in by ambulance and were assigned a triage category of 2 or 3, requiring urgent attention. A high proportion of 15-year-olds presented with alcohol excess/intoxication. In addition, 18-year-old males presented with laceration/wound/injury and reported alleged assault. Content analysis revealed complex insights into concerning risky event related behaviours and the context of their alcohol consumption, prior to presenting, including alleged physical and sexual assaults, psychosocial issues, and polysubstance use. Often younger people were found in fields, parks, and unstructured environments alone, with vary levels of consciousness, which places them in even greater danger. 

Conclusion

Two highly vulnerable age groups were identified with specific presenting complaints. This study has shown the myriad of risks facing young people with particular concern for 15-year-olds and 18-year- olds. The findings inform policy decisions, clinical practice and public health planning around alcohol-related care and treatment of young people. In addition, given the importance of 15 and 18-year-old age groups and the differences in life stages at these times, it is important to specifically design prevention and harm-reduction programs for these two target groups.