The impact of alcohol intoxication in patients admitted due to assault at an Australian major trauma centre: a trauma registry study from 1999 to 2009
- 1Trauma Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- 2Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- 3Department of Trauma Services, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- 4The Injury Division, The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
- 5Injury and Musculoskeletal Division, The George Institute for Global Health, Sydney, New South Wales, Australia
- Correspondence to Dr Michael Dinh, Trauma Department, Royal Prince Alfred Hospital, Level 10, Missenden Road, Camperdown, NSW 2050, Australia;
- Received 16 October 2012
- Revised 10 December 2012
- Accepted 29 January 2013
- Published Online First 16 February 2013
Objective To examine the long term trend in assault admissions at an inner city major trauma centre and determine the association between clinical evidence of alcohol intoxication and major trauma due to assault.
Methods Adult trauma patients admitted due to assault between 1999 and 2009 were identified through the hospital based trauma registry at an inner city major trauma centre in Sydney. Demographic data, incident details, clinical evidence of alcohol intoxication, injury severity scores and injury related outcomes were collected. Population based incidences were calculated and outcomes compared between intoxicated and non-intoxicated patients. Major trauma was defined as a composite outcome of severe injury (injury severity score>15), intensive care admission or in-hospital mortality.
Results There were 2380 patients analysed. Clinical evidence of alcohol intoxication was documented in 12% (287/2380) of cases. There was a marked peak in incidence of hospital admissions due to assault which occurred between 2000 and 2002. Overall, the rate of hospital admissions due to assault decreased during the study period (incident rate ratios 0.94, 95% CI 0.90 to 0.99, p<0.001). The odds of major trauma were three times higher in patients with clinical evidence of intoxication compared to those that did not (adjusted OR 2.9, 95% CI 2.1 to 4.0, p<0.001).
Conclusions There was a peak in hospital admissions due to inner city assault around 2000–2002 associated with an overall decline in hospital admissions at this trauma centre over 10 years. Clinical evidence of alcohol intoxication in patients admitted for assault appears to be associated with more severe injury, including severe head injury.