TY  - JOUR
PY  - 2021//
TI  - Predictors of clinical severity in subjects attending the Emergency Department for substance use: a ten-year cross-sectional study
JO  - American journal of emergency medicine
A1  - Covino, Marcello
A1  - Di Nicola, Marco
A1  - Pepe, Maria
A1  - Moccia, Lorenzo
A1  - Panaccione, Isabella
A1  - Lanzotti, Pierluigi
A1  - Montanari, Silvia
A1  - Janiri, Luigi
A1  - Sani, Gabriele
A1  - Franceschi, Francesco
SP  - 287
EP  - 290
VL  - 49
IS  - 
N2  - 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>
LA  - en
SN  - 0735-6757
UR  - http://dx.doi.org/10.1016/j.ajem.2021.06.022
ID  - ref1
ER  -