Mortality Risk Following Nonfatal Injuries With Alcohol Use Disorder Involvement: A One-Year Follow-Up of Emergency Department Patients Using Linked Administrative Data.

objectivePatient presentations to the emergency department (ED) for alcohol-involved injury represent a growing public health burden, but their characteristics and sequelae remain understudied. This study examined mortality rates among ED patients presenting with alcohol-involved injuries and assessed how mortality varied by injury intent and other characteristics.

methodThis retrospective cohort study used statewide, longitudinally linked ED patient record and mortality data from California. Participants comprised all residents presenting to a licensed ED in 2009-2012 with a nonfatal injury that involved comorbid diagnosis of alcohol use disorder (AUD;

resultsMost ED injury visits involving an AUD diagnosis were coded as unintentional (75.9%). Following the index ED visit, all-cause mortality among AUD-involved injury patients was 5,205 per 100,000 person-years, five times higher than the demographically matched population (SMR = 5.3; 95% confidence interval [5.2, 5.4]). Adjusted Cox regression models indicated that patients whose index injury was unintentional, and whose AUD was for acute intoxication, had significantly higher mortality. Most deaths among unintentionally injured patients were from natural causes, whereas external-cause deaths were relatively more common in the other patient groups.

conclusionsAUD-involved injury presentations to the ED in California are common and associated with high patient mortality burden, which varies by injury intent. Interventions are needed to reduce excess mortality in these patients.