@article{ref1,
title="Predictors of clinical severity in subjects attending the Emergency Department for substance use: a ten-year cross-sectional study",
journal="American journal of emergency medicine",
year="2021",
author="Covino, Marcello and Di Nicola, Marco and Pepe, Maria and Moccia, Lorenzo and Panaccione, Isabella and Lanzotti, Pierluigi and Montanari, Silvia and Janiri, Luigi and Sani, Gabriele and Franceschi, Francesco",
volume="49",
number="",
pages="287-290",
abstract="OBJECTIVE: Substance-related referrals to the Emergency Department (ED) are rising. Multiple substance use is frequent, and psychiatric patients represent a high-risk population. Our study aimed at identifying risk factors for increased severity in ED attendances for substance use. METHODS: We retrospectively evaluated consecutive patients attending the ED over ten years for substance-related problems, subdivided according to the triage code as having a life-threatening (LT), potentially life-threatening (P-LT), and non-life-threatening (N-LT) condition. RESULTS: Substance/drug intake for deliberate self-harm was a risk factor for being classified as LT compared to both P-LT (OR = 6.357; p ≤ 0.001) and N-LT (OR = 28.19; p ≤ 0.001). Suicide attempts (OR = 4.435; p = 0.022) and multiple substance use (OR = 1.513; p = 0.009) resulted as risk factors for P-LT, compared to N-LT. Psychiatric diagnosis (OR = 1.942; p = 0.042) and multiple substance use (OR = 1.668; p = 0.047) were risk factors for being classified as LT rather than N-LT. CONCLUSIONS: In our sample, self-harming overdoses were the strongest risk factor for highest overall severity in a real-world setting. Psychiatric disorders and multiple substance use also increased the risk for greater severity at presentation. Substance use worsens patients' clinical picture and management, suggesting the need for consultation-liaison psychiatry services in emergency contexts and highlighting the role of EDs as key sites for identification and early intervention.<p /><p>Language: en</p>",
language="en",
issn="0735-6757",
doi="10.1016/j.ajem.2021.06.022",
url="http://dx.doi.org/10.1016/j.ajem.2021.06.022"
}