title: The impact of smoking-related illness in the ED: an attributable risk model.
abstract: The objective of this study was to estimate the clinical and economic impact of smoking among adult emergency department (ED) patients. An attributable risk analysis of patients seen in 2 urban EDs in 1998 was performed. Data were obtained from hospital databases, national sources describing the prevalence of smoking in the state, and risk ratios for smoking-related illnesses. Of 78,617 patient visits, 12,573 (16.0%) had any smoking-related International Classification of Diseases, 9th Revision code. The smoking-attributable risk fraction (SARF) for all patients was 4.9% (95% confidence interval [CI] 4.7%-5.0%). Of 13,245 admissions, 6.8% (95% CI 6.4%-7.2%) were smoking attributable. Of $296,962,685 in hospital charges, 10.0% (95% CI 9.9%-10.1%) were smoking attributable. The SARFs for ED visits, admissions, and charges for men were higher than for women (all P <.0001). Smoking-attributable illness accounts for 4.9% of ED adult visits, 6.8% of ED adult admissions, and 10.0% of hospital charges. The use of ED-based smoking intervention remains to be determined.
authors: Department of Emergency Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA. sberns3966@aol.com
authors: Steven L
authors: SL
authors: Bernstein
mesh_terms: D000328:Adult; D002056:Burns / Q000453:epidemiology / Q000209:etiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D009518:New York / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012306:Risk; D012907:Smoking / Q000009:adverse effects*