2013-2023年马萨诸塞州使用紧急医疗服务记录的酒精相关遭遇监测

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-08-05 DOI:10.1016/j.drugalcdep.2025.112819

Amy Bettano , Ridgely Ficks , Gerard Gonzales , Matthew Blackburn , Joji Suzuki , Peter R. Chai , Dana Bernson , Charlotte Goldfine , Jonathan L. Burstein

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引用次数: 0

摘要

酒精是美国最常用的物质之一。由于酒精是一种广泛使用的主流法律物质，因此很难通过自我报告或医疗记录来准确评估酒精使用情况。在紧急医疗服务（EMS）记录中确定与酒精有关的遭遇提供了关于酒精使用的额外数据。方法利用马萨诸塞州救护车行程记录信息系统（matrix），根据酒精相关词汇和症状，对EMS中酒精相关遭遇（AREs）进行定义。另一个定义标记了与酒精戒断或解毒（ARE WD）有关的AREs。结果：审稿人评估了超过450个病例，以完善定义，导致95%的病例的正确表征（Cohen 's Kappa= 0.95, 95%置信区间：0.89,1.00）。ARE定义适用于2013年至2023年期间马萨诸塞州所有紧急EMS事故（n = 8530014）。其中3.28% （95% ci: 3.27% - 3.29%）为急性酒精中毒，15.29% （95% ci: 15.16% - 15.42%）有酒精戒断或解毒症状。在COVID-19大流行期间，这两种类型的酒精相关遭遇都有所增加（2020-2021年，p < 0.05）。与非are EMS相比，AREs的亚洲/太平洋岛民非西班牙裔/拉丁裔（nH/L）（非AREs的1.2%对AREs的1.3%）、黑人nH/L（5.0%对6.4%）和西班牙裔/拉丁裔患者（6.4%对8.4%）的比例更高（p < 0.001）。结论：ares记录的酒精使用比问题使用或成瘾更广泛，但存在观察偏差，因为并非所有使用都会导致EMS呼叫。可在现有的EMS记录中确定酒精使用情况，但需要进一步研究以了解AREs与其他酒精使用指标之间的关系。

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Alcohol-related encounter surveillance using emergency medical service records in Massachusetts, 2013–2023

Background

Alcohol is one of the most used substances in the United States. It can be hard to accurately assess alcohol use through self-report or medical records because it is a widespread mainstream legal substance. Identifying alcohol-related encounters in emergency medical services (EMS) records provides additional data on alcohol use.

Methods

We used the Massachusetts Ambulance Trip Record Information System (MATRIS) to develop a definition for alcohol-related encounters (AREs) in EMS encounters based on alcohol-related words and symptoms. An additional definition flagged AREs related to alcohol withdrawal or detoxification (ARE WD).

Results

Reviewers assessed over 450 cases to refine definitions resulting in a correct characterization of 95 % of cases (Cohen’s Kappa= 0.95, 95 % Confidence Intervals: 0.89, 1.00). The ARE definitions were applied to all Massachusetts emergency EMS encounters between 2013 and 2023 (n = 8530014). Of those, 3.28 % (95 % CIs: 3.27 %-3.29 %) were AREs while 15.29 % of AREs (95 % CIs: 15.16 %-15.42 %) had symptoms of alcohol withdrawal or detoxification. Both types of alcohol-related encounters increased during the COVID-19 pandemic (2020–2021, p < 0.05). Compared to non-ARE EMS encounters, AREs had a greater proportion of Asian/Pacific Islander non-Hispanic/Latine (nH/L) (1.2 % of non-AREs versus 1.3 % of AREs), Black nH/L (5.0 % versus 6.4 %), and Hispanic/Latine patients (6.4 % versus 8.4 %) (p < 0.001).

Conclusions

AREs document alcohol use broader than problematic use or addiction but are subject to observation bias since not all use results in an EMS call. Alcohol use can be identified in existing EMS records however additional research is needed to understand the relationship between AREs and other alcohol use indicators.

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.