Research status of clinical risk assessment in patients with acute alcohol intoxication_West China Medical Journal

Authors：

ZHENG Aiyi ,  YAO Rong

Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YAO Rong, Email: yaorong@wchscu.cn

Keywords：

Acute alcohol intoxication; clinical risk assessment; prognosis; risk factor; medical resources

DOI：

10.7507/1002-0179.202405066

Video：

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Acute alcohol intoxication is one of the most common poisoning diseases in emergency departments. The main clinical manifestations are nervous system symptoms, with various comorbidities, hidden complications, and high risk of adverse events, and it often takes up more medical resources in emergency departments. This article summarizes the necessity, basis, and existing methods of clinical risk assessment for acute alcohol intoxication, in order to provide a reference for early identification of high-risk patients and optimization of management in emergency departments.

Citation： ZHENG Aiyi, YAO Rong. Research status of clinical risk assessment in patients with acute alcohol intoxication. West China Medical Journal, 2024, 39(6): 976-979. doi: 10.7507/1002-0179.202405066 Copy

1.	急性酒精中毒诊治共识专家组. 急性酒精中毒诊治共识. 中华急诊医学杂志, 2014, 23(2): 135-138.
2.	Mullins PM, Mazer-Amirshahi M, Pines JM. Alcohol-related visits to US emergency departments, 2001-2011. Alcohol Alcohol, 2017, 52(1): 119-125.
3.	Verheij C, Rood PPM, Deelstra CK, et al. Emergency department visits due to intoxications in a Dutch university hospital: occurrence, characteristics and health care costs. PLoS One, 2019, 14(12): e0226029.
4.	蒲立力, 崔欣, 谢桦, 等. 上海市 2016-2018 年急性中毒病例发病特征. 环境与职业医学, 2020, 37(1): 63-68.
5.	蒋武, 王业强. 2019-2021 年重庆市急救医疗中心急性酒精中毒病例流行特征及时间序列分析. 中国当代医药, 2023, 30(29): 155-158.
6.	Rönz K, Hirschi T, Becker S, et al. Predictors of high resource consumption in alcohol intoxicated patients in the emergency department. Int J Environ Res Public Health, 2020, 17(11): 4122.
7.	Pigeaud L, de Veld L, van Hoof J, et al. Acute alcohol intoxication in Dutch adolescents before, during, and after the first COVID-19 lockdown. J Adolesc Health, 2021, 69(6): 905-909.
8.	GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
9.	余波, 李雪梅, 王志芳. 昆明市 17139 例急性酒精中毒院外急救分析. 中国急救复苏与灾害医学杂志, 2018, 13(1): 75-76.
10.	Piccioni A, Tarli C, Cardone S, et al. Role of first aid in the management of acute alcohol intoxication: a narrative review. Eur Rev Med Pharmacol Sci, 2020, 24(17): 9121-9128.
11.	Lee S, Oh H. Triage and length of stay in emergency department visits due to alcohol intoxication: a retrospective chart review. Australas Emerg Care, 2023, 26(1): 90-95.
12.	White AM, Slater ME, Ng G, et al. Trends in alcohol-related emergency department visits in the United States: results from the nationwide emergency department sample, 2006 to 2014. Alcohol Clin Exp Res, 2018, 42(2): 352-359.
13.	Stang JL, DeVries PA, Klein LR, et al. Medical needs of emergency department patients presenting with acute alcohol and drug intoxication. Am J Emerg Med, 2021, 42: 38-42.
14.	Marshall B, McGlynn E, King A. Sobering centers, emergency medical services, and emergency departments: a review of the literature. Am J Emerg Med, 2021, 40: 37-40.
15.	黄国清. 分级护理在急性酒精中毒患者护理中的应用效果. 保健医学研究与实践, 2022, 19(11): 99-102.
16.	谢培英, 吴春迎, 吴晓凤. 全程优质护理在酒精中毒性精神障碍中的应用. 深圳中西医结合杂志, 2022, 32(14): 129-132.
17.	D’Angelo A, Petrella C, Greco A, et al. Acute alcohol intoxication: a clinical overview. Clin Ter, 2022, 173(3): 280-291.
18.	Klein LR, Cole JB, Driver BE, et al. Unsuspected critical illness among emergency department patients presenting for acute alcohol intoxication. Ann Emerg Med, 2018, 71(3): 279-288.
19.	Dua KS, Surapaneni SN, Santharam R, et al. Effect of systemic alcohol and nicotine on airway protective reflexes. Am J Gastroenterol, 2009, 104(10): 2431-2438.
20.	Miner JR, Gaetz A, Biros MH. The association of a decreased level of awareness and blood alcohol concentration with both agitation and sedation in intoxicated patients in the ED. Am J Emerg Med, 2007, 25(7): 743-748.
21.	Mirijello A, Sestito L, Antonelli M, et al. Identification and management of acute alcohol intoxication. Eur J Intern Med, 2023, 108: 1-8.
22.	于学忠, 黄子通. 急诊医学. 北京: 人民卫生出版社, 2015: 452-453.
23.	Marshall AW, Kingstone D, Boss M, et al. Ethanol elimination in males and females: relationship to menstrual cycle and body composition. Hepatology, 1983, 3(5): 701-706.
24.	Frezza M, di Padova C, Pozzato G, et al. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med, 1990, 322(2): 95-99.
25.	Sauter TC, Rönz K, Hirschi T, et al. Intubation in acute alcohol intoxications at the emergency department. Scand J Trauma Resusc Emerg Med, 2020, 28(1): 11.
26.	Jung YC, Namkoong K. Alcohol: intoxication and poisoning - diagnosis and treatment. Handb Clin Neurol, 2014, 125: 115-121.
27.	Olson KN, Smith SW, Kloss JS, et al. Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol Alcohol, 2013, 48(4): 386-389.
28.	陈意飞, 郭明, 董世童, 等. 急性酒精中毒风险防范的现状与思考. 中华卫生应急电子杂志, 2019, 5(1): 36-37.
29.	刘天荣, 张静, 陈瑢. 红细胞宽度水平与急性中、重度酒精中毒病情危重程度的相关性研究. 检验医学与临床, 2016, 13(17): 2504-2505.
30.	Conzelmann M, Hoidis A, Bruckner T, et al. Aspiration risk in relation to Glasgow Coma Scale score and clinical parameters in patients with severe acute alcohol intoxication: a single-centre, retrospective study. BMJ Open, 2021, 11(10): e053619.
31.	de Veld L, van der Lely N, Hermans BJM, et al. QTc prolongation in adolescents with acute alcohol intoxication. Eur J Pediatr, 2022, 181(7): 2757-2770.
32.	Niemelä O, Halkola AS, Bloigu A, et al. Blood cell responses following heavy alcohol consumption coincide with changes in acute phase reactants of inflammation, indices of hemolysis and immune responses to ethanol metabolites. Int J Mol Sci, 2022, 23(21): 12738.
33.	Palmese F, Bonavita ME, Pompili E, et al. Mortality and its association with chronic alcohol-related diseases in patients admitted to the emergency department for acute alcoholic intoxication: retrospective cohort study. Intern Emerg Med, 2023, 18(1): 257-263.
34.	World Health Organization. Global status report on alcohol and health 2018. Geneva: World Health Organization, 2018.
35.	Bilello J, McCray V, Davis J, et al. Acute ethanol intoxication and the trauma patient: hemodynamic pitfalls. World J Surg, 2011, 35(9): 2149-2153.
36.	Cairns R, Buckley NA. The poisoning severity score: if it did not exist, we would have to invent it. J Med Toxicol, 2017, 13(2): 131-134.
37.	Hack JB, Goldlust EJ, Gibbs F, et al. The H-Impairment Index (HII): a standardized assessment of alcohol-induced impairment in the Emergency Department. Am J Drug Alcohol Abuse, 2014, 40(2): 111-117.
38.	Hack JB, Goldlust EJ, Ferrante D, et al. Performance of the Hack’s impairment index score: a novel tool to assess impairment from alcohol in emergency department patients. Acad Emerg Med, 2017, 24(10): 1193-1203.
39.	Benoit JL, Hart KW, Soliman AA, et al. Developing a standardized measurement of alcohol intoxication. Am J Emerg Med, 2017, 35(5): 725-730.
40.	Volz TM, Boyer KS. The development of a behaviorally-based alcohol intoxication scale. J Emerg Nurs, 2014, 40(4): 330-335.

1. 急性酒精中毒诊治共识专家组. 急性酒精中毒诊治共识. 中华急诊医学杂志, 2014, 23(2): 135-138.
2. Mullins PM, Mazer-Amirshahi M, Pines JM. Alcohol-related visits to US emergency departments, 2001-2011. Alcohol Alcohol, 2017, 52(1): 119-125.
3. Verheij C, Rood PPM, Deelstra CK, et al. Emergency department visits due to intoxications in a Dutch university hospital: occurrence, characteristics and health care costs. PLoS One, 2019, 14(12): e0226029.
4. 蒲立力, 崔欣, 谢桦, 等. 上海市 2016-2018 年急性中毒病例发病特征. 环境与职业医学, 2020, 37(1): 63-68.
5. 蒋武, 王业强. 2019-2021 年重庆市急救医疗中心急性酒精中毒病例流行特征及时间序列分析. 中国当代医药, 2023, 30(29): 155-158.
6. Rönz K, Hirschi T, Becker S, et al. Predictors of high resource consumption in alcohol intoxicated patients in the emergency department. Int J Environ Res Public Health, 2020, 17(11): 4122.
7. Pigeaud L, de Veld L, van Hoof J, et al. Acute alcohol intoxication in Dutch adolescents before, during, and after the first COVID-19 lockdown. J Adolesc Health, 2021, 69(6): 905-909.
8. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
9. 余波, 李雪梅, 王志芳. 昆明市 17139 例急性酒精中毒院外急救分析. 中国急救复苏与灾害医学杂志, 2018, 13(1): 75-76.
10. Piccioni A, Tarli C, Cardone S, et al. Role of first aid in the management of acute alcohol intoxication: a narrative review. Eur Rev Med Pharmacol Sci, 2020, 24(17): 9121-9128.
11. Lee S, Oh H. Triage and length of stay in emergency department visits due to alcohol intoxication: a retrospective chart review. Australas Emerg Care, 2023, 26(1): 90-95.
12. White AM, Slater ME, Ng G, et al. Trends in alcohol-related emergency department visits in the United States: results from the nationwide emergency department sample, 2006 to 2014. Alcohol Clin Exp Res, 2018, 42(2): 352-359.
13. Stang JL, DeVries PA, Klein LR, et al. Medical needs of emergency department patients presenting with acute alcohol and drug intoxication. Am J Emerg Med, 2021, 42: 38-42.
14. Marshall B, McGlynn E, King A. Sobering centers, emergency medical services, and emergency departments: a review of the literature. Am J Emerg Med, 2021, 40: 37-40.
15. 黄国清. 分级护理在急性酒精中毒患者护理中的应用效果. 保健医学研究与实践, 2022, 19(11): 99-102.
16. 谢培英, 吴春迎, 吴晓凤. 全程优质护理在酒精中毒性精神障碍中的应用. 深圳中西医结合杂志, 2022, 32(14): 129-132.
17. D’Angelo A, Petrella C, Greco A, et al. Acute alcohol intoxication: a clinical overview. Clin Ter, 2022, 173(3): 280-291.
18. Klein LR, Cole JB, Driver BE, et al. Unsuspected critical illness among emergency department patients presenting for acute alcohol intoxication. Ann Emerg Med, 2018, 71(3): 279-288.
19. Dua KS, Surapaneni SN, Santharam R, et al. Effect of systemic alcohol and nicotine on airway protective reflexes. Am J Gastroenterol, 2009, 104(10): 2431-2438.
20. Miner JR, Gaetz A, Biros MH. The association of a decreased level of awareness and blood alcohol concentration with both agitation and sedation in intoxicated patients in the ED. Am J Emerg Med, 2007, 25(7): 743-748.
21. Mirijello A, Sestito L, Antonelli M, et al. Identification and management of acute alcohol intoxication. Eur J Intern Med, 2023, 108: 1-8.
22. 于学忠, 黄子通. 急诊医学. 北京: 人民卫生出版社, 2015: 452-453.
23. Marshall AW, Kingstone D, Boss M, et al. Ethanol elimination in males and females: relationship to menstrual cycle and body composition. Hepatology, 1983, 3(5): 701-706.
24. Frezza M, di Padova C, Pozzato G, et al. High blood alcohol levels in women. The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med, 1990, 322(2): 95-99.
25. Sauter TC, Rönz K, Hirschi T, et al. Intubation in acute alcohol intoxications at the emergency department. Scand J Trauma Resusc Emerg Med, 2020, 28(1): 11.
26. Jung YC, Namkoong K. Alcohol: intoxication and poisoning - diagnosis and treatment. Handb Clin Neurol, 2014, 125: 115-121.
27. Olson KN, Smith SW, Kloss JS, et al. Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol Alcohol, 2013, 48(4): 386-389.
28. 陈意飞, 郭明, 董世童, 等. 急性酒精中毒风险防范的现状与思考. 中华卫生应急电子杂志, 2019, 5(1): 36-37.
29. 刘天荣, 张静, 陈瑢. 红细胞宽度水平与急性中、重度酒精中毒病情危重程度的相关性研究. 检验医学与临床, 2016, 13(17): 2504-2505.
30. Conzelmann M, Hoidis A, Bruckner T, et al. Aspiration risk in relation to Glasgow Coma Scale score and clinical parameters in patients with severe acute alcohol intoxication: a single-centre, retrospective study. BMJ Open, 2021, 11(10): e053619.
31. de Veld L, van der Lely N, Hermans BJM, et al. QTc prolongation in adolescents with acute alcohol intoxication. Eur J Pediatr, 2022, 181(7): 2757-2770.
32. Niemelä O, Halkola AS, Bloigu A, et al. Blood cell responses following heavy alcohol consumption coincide with changes in acute phase reactants of inflammation, indices of hemolysis and immune responses to ethanol metabolites. Int J Mol Sci, 2022, 23(21): 12738.
33. Palmese F, Bonavita ME, Pompili E, et al. Mortality and its association with chronic alcohol-related diseases in patients admitted to the emergency department for acute alcoholic intoxication: retrospective cohort study. Intern Emerg Med, 2023, 18(1): 257-263.
34. World Health Organization. Global status report on alcohol and health 2018. Geneva: World Health Organization, 2018.
35. Bilello J, McCray V, Davis J, et al. Acute ethanol intoxication and the trauma patient: hemodynamic pitfalls. World J Surg, 2011, 35(9): 2149-2153.
36. Cairns R, Buckley NA. The poisoning severity score: if it did not exist, we would have to invent it. J Med Toxicol, 2017, 13(2): 131-134.
37. Hack JB, Goldlust EJ, Gibbs F, et al. The H-Impairment Index (HII): a standardized assessment of alcohol-induced impairment in the Emergency Department. Am J Drug Alcohol Abuse, 2014, 40(2): 111-117.
38. Hack JB, Goldlust EJ, Ferrante D, et al. Performance of the Hack’s impairment index score: a novel tool to assess impairment from alcohol in emergency department patients. Acad Emerg Med, 2017, 24(10): 1193-1203.
39. Benoit JL, Hart KW, Soliman AA, et al. Developing a standardized measurement of alcohol intoxication. Am J Emerg Med, 2017, 35(5): 725-730.
40. Volz TM, Boyer KS. The development of a behaviorally-based alcohol intoxication scale. J Emerg Nurs, 2014, 40(4): 330-335.

West China Medical Journal

Research status of clinical risk assessment in patients with acute alcohol intoxication

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