Evidence map›Paper›PMID 25479796›Full record

ArticleBMJ open2014

Survival of patients with alcohol use disorders discharged from an emergency department: a population-based cohort study.

Anna Steinunn Gunnarsdottir, Adalbjorg Kristbjornsdottir, Ragnhildur Gudmundsdottir, Oddny Sigurborg Gunnarsdottir, Vilhjalmur Rafnsson

Abstract readComparative Study
In one paragraph

Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna Steinunn GunnarsdottirFaculty of Medicine, The Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
Adalbjorg KristbjornsdottirFaculty of Medicine, The Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
Ragnhildur GudmundsdottirFaculty of Medicine, The Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
Oddny Sigurborg GunnarsdottirLandspitali-the National University Hospital of Iceland, Reykjavik, Iceland.
Vilhjalmur RafnssonDepartment of Preventive Medicine, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim was to study the cause-specific mortality of users of the emergency department (ED) who received a diagnosis of alcohol use disorder (AUD) in comparison with mortality of other users of the department.

designA population-based prospective cohort study.

participantsAll patients aged 18 years and above who were subsequently discharged home from the ED during the years 2002-2008. A total of 107,237 patients were followed by record linkage to a nationwide cause-of-death registry: 1210 patients with AUD as the main discharge diagnosis and 106,027 patients in the comparison group. HR and 95% CIs were calculated.

settingED at Landspitali-the National University Hospital of Iceland, Reykjavik, Iceland. The hospital offers tertiary care and is the number one trauma centre and community hospital for the greater Reykjavik area. According to the population registry, 78% of the inhabitants of the area attended the ED during the study period.

results72 patients died in the AUD group and 4807 in the comparison group. The adjusted HR for all causes of death was 1.91 (95% CI 1.51 to 2.42). The HR for AUDs was 47.68 (95% CI 11.56 to 196.59) while for alcohol liver disease the HR was 19.06 (95% CI 6.07 to 59.87). The HR was also elevated for diseases of the circulatory system: HR 2.52 (95% CI 1.73 to 3.68); accidental poisoning: HR=13.64, (95% CI 3.98 to 46.73); suicide: HR=2.72 (95% CI 1.08 to 6.83); and event of undetermined intent: HR=10.89 (95% CI 4.53 to 26.16).

conclusionsAUD as the discharge diagnosis at the ED, among patients who were not admitted to a hospital ward but discharged home, predicts increased mortality. As the results conclusively show the vulnerability of these patients, one can question whether their needs are adequately met at the ED.

Indexed as

Population SurveillanceAdolescentAdultAgedAged, 80 and overAlcohol-Related DisordersCause of DeathEmergency Service, HospitalFemaleFollow-Up StudiesHumansIcelandMaleMiddle AgedPatient DischargeProspective StudiesACCIDENT & EMERGENCY MEDICINEEPIDEMIOLOGYMENTAL HEALTH

Identifiers

PMID25479796
PMCPMC4265137

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.