Alcohol-related injury in the ER: a cross-national meta-analysis from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP).
OBJECTIVE
To examine the impact of usual drinking patterns and related problems on the acute use of alcohol in injury.


METHODS
The impact of quantity and frequency of drinking, alcohol problems and dependence symptoms on admission to the emergency room (ER) for an alcohol-related injury (based, separately, on a positive blood alcohol concentration [BAC] and self-reported drinking within 6 hours prior to injury), compared with a nonalcohol related injury, was examined using meta-analysis, across 15 ER studies covering seven countries.


RESULTS
Pooled effect size for consuming five or more drinks on an occasion at least monthly was significant but not homogeneous, with odds ratios (ORs) of 4.16 for BAC and 3.92 for self-report. Frequency of drinking among nonheavy drinkers was found to have the largest effect size (5.93 for BAC and 4.93 for self-report). Heavy drinking, controlling for frequency, was also significant (ORs of 2.08 for BAC and 1.86 for self-report), but effect size was homogeneous only for self-report. Effect sizes for consequences of drinking and dependence symptoms were also significant and homogeneous, with ORs of 4.29 and 3.55, respectively, for BAC, and 3.84 and 3.94, respectively, for self-report. In meta-regression analysis, among contextual variables the level to which alcohol use is stigmatized in the culture was most consistently predictive of heavy-drinking effect size on an alcohol-related injury, with larger effect sizes found in those studies reporting a lower level of stigmatization.


CONCLUSIONS
Whereas quantity and frequency of drinking were both found to be highly predictive of an alcohol-related injury, sociocultural variables may affect observed associations of heavy drinking with an alcohol-related injury.
Public Health Institute, Alcohol Research Group, 2000 Hearst Avenue, Berkeley, California 94709, USA.
Cheryl J
CJ
Cherpitel
Jason
J
Bond
Yu
Y
Ye
Guilherme
G
Borges
Scott
S
MacDonald
Tim
T
Stockwell
Norman
N
Giesbrecht
Mariana
M
Cremonte
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D000435:Alcoholic Intoxication / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014947:Wounds and Injuries / Q000453:epidemiology*
D000431:Ethanol