The burden of ethanol-positive patients in emergency departments: a clinical evaluation

Aims: Alcohol-related emergency department (ED) admissions pose a significant burden on healthcare systems. This study aims to evaluate the demographic, clinical, and biochemical characteristics of ethanol-positive patients and analyze the impact of blood ethanol levels on the emergency department. Methods: This retrospective study included 769 patients who presented to a tertiary care ED between November 1, 2023, and April 30, 2024, with a blood ethanol level >50 mg/dL. Patients were categorized into two groups (<200 mg/dL and >200 mg/dL), and their demographic data, admission reasons, biochemical parameters, and brain computed tomography (CT) findings were compared. Results: The mean age of the study population was 38.24 ± 13.81 years, and 80% were male. Patients in the >200 mg/dL group were significantly older than those in the <200 mg/dL group. Trauma was the leading cause of ED admission (90% of cases), with falls being more common in the >200 mg/dL group (19.9% vs. 8.4%, p<0.001) and assaults being more frequent in the <200 mg/dL group (25.5% vs. 18.2%, p<0.001). Biochemical analysis showed significant elevations in AST, amylase, and lipase levels in the >200 mg/dL group. Brain CT scans were performed in 54.4% of patients, with no significant differences in intracranial pathology between groups (p=0.427). Conclusion: Alcohol-related ED visits contribute to both clinical and operational challenges. Patients with ethanol levels >200 mg/dL were more advanced in age and had higher rates of trauma-related admissions, particularly falls. Despite increased brain CT utilization in this group, no significant difference was found in intracranial pathology rates. These findings highlight the need for more selective imaging strategies. Additionally, targeted interventions such as alcohol screening protocols, specialized sobering units, and staff training programs are essential to reducing the burden of alcohol-related ED visits and improving patient care.