東部某醫學中心急診傷患之酒後事故

Alcohol-related Injured Patients Seen in Emergency Department from a Medical Center in Eastern Taiwan

10.7023/TJFM.200503.0001

李燕嗚(Yin-Ming Li)；傅振宗(Chen-Chung Fu)

alcohol-related injury ； physicians' records ； previous alcohol-related injuries ； history of alcohol abuse ； emergency department

台灣家庭醫學雜誌

15卷1期（2005 / 03 / 01）

1 - 10

繁體中文

過量飲酒增加事故傷害的風險，世界衛生組織建議飲酒評估是基本外傷監控項目，國內急診醫師記錄傷患酒後情況缺資料，本文目的調查醫師記錄酒後傷患的現況，比較酒後與非酒後傷患有他次酒後傷害或酒精濫用病史的差異。本研究在民國91年10月至92年4月間進行，臺灣東部一所醫學中心，年齡12歲以上之急診外傷傷患為研究對象，選取護理人員辨認為酒後、不確定和無酒味傷患共約1390位，由一位具公共衛生訓練的專任助理，查閱該次病歷內醫師有關傷患飲酒評估的記錄，前期他次酒後外傷求診、酒精濫用史和精神科疾病診斷。結果發現經護理人員辨認為有酒味或明顯酒醉傷患（478位），20.5%有他次酒後傷害急診記錄，18.4%有酒精濫用史，酒後較非酒後傷患高出六倍機會可發現有他次酒後傷害記錄、約八倍機會有酒精濫用史；2.9%曾有精神科疾病診斷。酒後傷患約六成醫師病歷內無記錄，54.6%醫師有記錄酒後傷患，但是未有檢驗酒精濃度。可見現時醫師登錄酒後的比例不理想，應進一步評估急診醫療中偵察酒後事故、篩檢酒精濫用及戒酒諮詢的可行性。

Excessive alcohol drinking increases the risk of accidents. The World Health Organization recommends that an assessment for alcohol use is an essential component of a surveillance system. In Taiwan, an assessment for alcohol use is not provided by the emergency physicians. The objective of this study was to investigate the number of physicians who record patients' alcohol drinking, previous alcohol-related injuries and history of alcohol abuse. This study was conducted from October 2002 to April 2003. Whether patients were with alcohol odor, were initially assessed by nurses. About 1,390 patients aged 12 or above were included in this study. The patients were identified as ”alcohol users”, and the control group were identified as ”non-alcohol users”. An assistant assessed for any other previous alcohol related injuries, history of alcohol abuse and any psychiatric diagnosis. A total of 478 injured patients were identified with an odor of alcohol, drunk or suspected drunk. Of those, 20.5% had previous records of alcohol-related injuries and, 18.4% had a history of alcohol abuse. Patients who were suspected of or who have evidence of alcohol use before the injury event were six times more likely to have other alcohol related injuries. Also, they were eight times more likely to have a history of alcohol abuse, and about 3% had a psychiatric diagnosis. There were no physicians' records about alcohol problems noted in about 60% of confirmed drunk patients. Among those patients whom the physician recorded to have alcohol use, 54.6% did not test for blood alcohol concentration. Currently, physicians' record of alcohol use is not good. Further study for the feasibility of alcoholism screening and brief consultation of alcohol use at emergency departments is crucial for injury control.

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