Focus on: the burden of alcohol use--trauma and emergency outcomes

Hospital emergency departments (EDs) see many patients with alcohol-related injuries and therefore frequently are used to assess the relationship between alcohol consumption and injury risk. These studies typically use either case-control or case-crossover designs. Case-control studies, which compare injured ED patients with either medical ED patients or the general population, found an increased risk of injury after alcohol consumption, but differences between the case and control subjects partly may account for this effect. Case-crossover designs, which avoid this potential confounding factor by using the injured patients as their own control subjects, also found elevated rates of injury risk after alcohol consumption. However, the degree to which risk is increased can vary depending on the study design used. Other factors influencing injury risk include concurrent use of other drugs and drinking patterns. Additional studies have evaluated cross-country variation in injury risk as well as the risk by type (i.e., intentional vs. unintentional) and cause of the injury. Finally, ED studies have helped determine the alcohol-attributable fraction of injuries, the causal attribution of injuries to drinking, and the impact of others' drinking. Although these studies have some limitations, they have provided valuable insight into the association between drinking and injury risk.