ALCOHOL-ASSOCIATED DISEASES IN INTERNAL-M EDICINE - A SCREENING STUDYON 1494 MEDICAL EMERGENCY PATIENTS

Alcohol represents the most significant medicosocial problem facing Ge rmany today Quantification of alcohol-related costs to the public heal th system is usually based on insurance and accident statistics or on studies with addiction-related or psychiatric focus. Data regarding al cohol-related diseases in medical emergency admissions in Germany howe ver have not been available. Using a specially developed assignment di agram, a total of 1 494 medical emergency patients were screened betwe en lune and December 1995. 206 of these patients were included in the present study Directly or indirectly alcohol-related diseases were fou nd in 15.7% (n = 206 males 83%, females 17%) of all emergency admissio ns. According to ICD-10, 34.5% of the patients admitted suffered from psychical behavior disorders incl. suicide attempt 8.3% from neurologi c diseases incl. cerebrovascular diseases, 75.5% from cardiovascular d iseases and 23.3% from gastroenterologic diseases incl. esophageal var ices. Acute alcohol intoxication was found in 17.5% and 13.6% develope d delirium tremens The screening instrument which differs from test me thods already developed for use in addiction treatment programmes, det ected alcohol-related disorders in 15.7% of all medical emergency admi ssions and in 24.4% of patients aged less than 65 years. A screening s chema based on medical symptoms and findings for recognition of alcoho l-related disorders could be easily integrated into routine work-up of medical emergency admissions. The introduction of routine measurement of alcohol concentration in exhalation could be useful.