Objectives: The development of surrogate measures of acute alcohol-related injury for use in the evaluation of community-based prevention initiatives is described.
Methods: An international collaborative study of alcohol and injury (the Emergency Room Collaborative Alcohol Analysis Project or ERCAAP) provided a subset of data on 8,580 Emergency Room (ER) presentations from five countries and 28 ER facilities.
Results: Presentations between 10pm and 5.59am (46%), between 12am and 4.59am (56%), on Fridays, Saturdays or Sundays (26%) and also among injured persons who were male (28%), aged between 18 and 45 years (24%) or unmarried (24%) were most likely to be alcohol-related against these criteria. Multi-level logistic regression models confirmed the significance of the above variables as predicting alcohol involvement prior to the injury event. The strongest predictor variable was presentation between 12 midnight and 4.59am with an odds ratio of 4.92 (Wald Test Chi Sq = 397.6, p<0.001). Being male had an odds ratio of 3.01 (Wald Test Chi Square = 247.25, p<0.001), presenting on a Friday, Saturday or Sunday night an odds ratio of 1.50 (Wald Test Chi Sq = 49.6, p<0.001), while being under 45 (OR=1.20, p<0.05) and being unmarried (OR=1.2, p<0.01) were less strong predictors. Combining all these values for variables raised the probability of prior alcohol involvement in such injury presentations to 0.65, though only 3.37% of all cases met these criteria, limiting applicability as a surrogate measure for intervention studies. Probabilities of prior alcohol involvement are presented with other combinations of values for the predictor variables.
Conclusions: Frequency of night-time injury presentations to ER facilities, in particular by males, can be used as a reliable surrogate measure of alcohol-related injuries for various epidemiological and evaluation purposes.