35% of Injury-Related ER Visits in Ghana Alcohol-Related

Investigating a country’s alcohol-associated injury rate — and the groups most at risk — can help improve emergency care and inform public health policy, a U-M expert says.

7:00 AM

Author | Kylie Urban

Blurred picture of Ghana Alcohol

Emergency departments across the world see injuries every day.

In fact, injuries account for 10 percent of deaths worldwide, or nearly 6 million, with 90 percent of those deaths occurring in low- and middle-income countries, according to the World Health Organization. With the industrialization and economic growth of low- and middle-income countries, WHO expects these numbers to rise dramatically.

MORE FROM THE LAB: Subscribe to our weekly newsletter

"Those statistics highlight that injuries pose a global health concern," says Ronald Maio, D.O., professor emeritus of emergency medicine, member of the University of Michigan Injury Center and senior author of a new paper examining injuries in a Ghanaian emergency department. "Additionally troublesome, 15 to 20 percent of injuries worldwide are attributable to alcohol use."

The work was led by first author Paa Kobina Forson, M.D., M.P.H., as well as Andrew Gardner, M.D. Forson is an emergency medicine physician at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. At the time of the study, Gardner was a medical student at the University of Michigan Medical School and conducted the project for his Fogarty International Research Scholarship. George Oduro, M.D., director of the Accident and Emergency Medicine Department at KATH and assistant professor at U-M, also played a key role in the study.

Oduro says the team knew that injuries are responsible for 8 percent of all mortalities in Ghana, and that road traffic injuries were the most frequent cause of injury presenting to the KATH emergency department. However, they could not find any data or previous studies that described the frequency of alcohol-associated injury in Ghana.

The research team thought a study on alcohol-associated injury was important because the incidence of alcohol-associated injuries in many low- and middle-income countries remains unknown. Since 2007, the U-M Department of Emergency Medicine, through its Ghana Emergency Medicine Collaborative, has been helping train emergency medicine physicians and improve emergency care in Ghana.

"Information and data generated from a study can then be used to inform clinical and public health policies and interventions," Maio says. "And with alcohol-associated injuries accounting for that 15 to 20 percent of injuries worldwide, we want countries such as Ghana to be able to confidently report what types of injuries they are seeing in their emergency departments and use that information to improve the health of their citizens."

In the study, published in the October 2016 issue of Annals of Emergency Medicine, Forson, Gardner, Oduro, Maio and colleagues conducted a cross-sectional chart review of the 1,085 patients older than 18 who presented to the KATH emergency department, either directly or through a transfer from another facility, within eight hours of an injury.

Patients were screened for alcohol with a Breathalyzer or a saliva test. The researchers found 382 subjects, or 35 percent, tested positive for any level of alcohol in their systems.

Of the 382 subjects, certain groups more frequently had detectable alcohol in their systems, including:

  • 42 percent of men

  • 40 percent of people ages 25 to 44

  • 42 percent of drivers

  • 42 percent of pedestrians

  • 49 percent of those with assault injuries

  • 40 percent of those with serious injuries

  • 53 percent of those who died in the emergency department

"Our results resembled the global population of injured patients," Maio says, "in that roughly twice as many men than women were injured; young adults were the largest age demographic; and road traffic injuries were the most common type of injury."

He adds, "We did find that our results showed higher numbers of positive alcohol tests than might be expected, according to the World Health Organization and health status report for Ghana. Our 35 percent finding was also higher than the global average estimate of alcohol-associated injury. Our results demonstrate the need for low- and middle-income countries to conduct their own research rather than extrapolating from general-population estimates from the World Health Organization."

Our results demonstrate the need for low- and middle-income countries to conduct their own research rather than extrapolating from general-population estimates from the WHO.
Ronald F. Maio, D.O.

A need for more research

Maio and the research team hope the study results help Ghanaians with clinical care and public health policies.

Oduro says the presence of alcohol can increase the difficulties of making an accurate diagnosis and can affect the subsequent treatment and outcome of the patient. He thinks their findings support the need for alcohol testing among injured patients in low- and middle-income countries, and further research into developing specific clinical protocols that can use this information to deliver more appropriate care.

Maio says that in the United States and Europe, injured patients who test positive for alcohol in their systems are often further evaluated, and treatment is initiated for alcohol abuse and harmful patterns of drinking in hopes of preventing future alcohol-related injuries. He and his colleagues say research needs to be conducted to determine the best way to deliver similar services in Ghana and other low- and middle-income countries.

The study also notes that Ghana has a national maximum blood alcohol content of 0.08 percent for drivers, but there is no written national policy or action plan on preventing drunken driving, and the national legal minimum age of 18 for alcohol sales is not routinely enforced. Forson says public health strategies need to be developed and tested to limit alcohol-related injuries, particularly among road users.


More Articles About: Industry DX Urgent Care Emergency & Trauma Care
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Hospital bed
Health Lab
SAEM 2019: Gun Safety, Over Testing and More
Michigan Medicine experts highlighted new research during the keynote address and plenary session at the annual Society for Academic Emergency Medicine Annual Meeting.
Health Lab
Patient Visits Higher at Rural Emergency Departments
A new study found that rural emergency department visits grew by 50 percent during a 12-year timeframe, suggesting that rural emergency departments serve as safety nets for many patients.
Health Lab
Just 5% of Patients Account for a Third of ICU Time
University of Michigan study shows that persistent critically ill patients, 5% of all ICU patients, use 33% of of health care resources.
gun with lock on it with key there gun is in black and background yellow and lock is white
Health Lab
Michigan’s new firearm injury prevention laws: What everyone should know
Michigan has a set of new laws related to firearms, all designed to reduce the risk of injury and death across the state.
computer
Health Lab
Same patient. Different visit. Different race and ethnicity?
Data on the race and ethnicity of patients underpins efforts to reduce health care disparities, but a study shows inconsistent recording in emergency departments
Girl participates in rehab activities, playing with shapes on a board and using an exercise ball
Health Lab
Pediatric neuro rehabilitation program provides answers for 10-year-old with a traumatic brain injury
The University of Michigan Health Milestones Pediatric Neuro Rehabilitation Program specializes in evaluating and treating children with an acute neurological diagnosis from an injury or illness.