응급의료센터에 내원한 중증 알코올 중독 환자 선별을 위한 중증도 분류도구의 유용성 = The Validity of the Triage Tool as a Method to Screen Severe Alcoholic Intoxication Patients in the Emergency Department

다국어 초록 (Multilingual Abstract)

Purpose: Altered mental status is common to alcohol intoxicated patients, resulting in difficulties to perform detailed physical examination and history taking. With this condition, the development of appropriate tools for evaluation was required. This study was conducted to investigate a better method for predicting the prognosis among alcohol intoxicated patients in the emergency department by modifying the Korean Triage Acuity Scale (KTAS).
Methods: We retrospectively reviewed the medical records of 1,155 alcohol intoxicated patients who presented to the ED between January and December of 2013. The correlation between admission and demographical characteristics of patients was analyzed. We applied the clinical values to KTAS (overdose category) and modified KTAS (alcoholic intoxication category).
The efficiency of two triage methods was compared by using the receiver operating characteristic (ROC) curve analysis.
Results: Among these 1,155 patients, 201 were admitted and 954 were discharged. The sensitivity and specificity of the overdose category were 0.736 and 0.623, respectively. Those of the alcoholic intoxication category were 0.647 and 0.979, respectively. The area under ROC curves for overdose category and alcoholic intoxication category were 0.679± 0.020 and 0.813±0.021, respectively (95% confidence interval, p<0.001).
Conclusion: This study showed that the sensitivities of the overdose category and the alcoholic intoxication category were similar. However, the specificity of the alcoholic intoxication category was higher than that of the overdose category.
Therefore, the alcoholic intoxication category was superior to the overdose category in predicting the prognosis among alcohol intoxicated patients.

참고문헌 (Reference)

1 김태근, "중증도 분류 도구로 mESI-2의 효용성 평가" 대한응급의학회 17 (17): 154-164, 2006

2 나백주, "응급의료센터를 보유한 의료기관 입원 중 응급실경유입원 관련 요인" 한국보건행정학회 19 (19): 71-84, 2009

3 황순영, "응급실에서 위험 음주군 선별을 위한 음주량 기준 도구의 유용성" 대한응급의학회 21 (21): 199-206, 2010

4 최윤희, "외상환자에서 알코올 섭취가 손상의 중증도에 미치는 영향에 대한 연구" 대한응급의학회 17 (17): 231-237, 2006

5 이운정, "급성 중독 환자의 임상 양상에 알코올 섭취가 미치는 영향" 대한응급의학회 20 (20): 115-121, 2009

6 Jo JB, "Twelve-month prevalence and correlates of hazardous drinking : results from a community sample in Seoul, Korea" 15 : 65-74, 2011

7 Lee HK, "The prevalence and correlates of alcohol use disorders in the United States and Korea--a cross-national comparative study" 44 : 297-306, 2010

8 Seoul National University College of Med, "The epidemiological survey of mental disorders in Korea 2011" Ministry of Health and Welfare 2012

9 Bullard MJ, "Revisions to the Canadian Emergency Department Triage and Acuity Scale(CTAS)guidelines" 16 : 485-489, 2014

10 Christ M, "Modern triage in the emergency department" 107 : 892-898, 2010

11 Sereny G, "Mechanism and significance of carbohydrate intolerance in chronic alcoholism" 27 : 1041-1046, 1978

12 Seo JS, "Etiology and clinical characteristics of alcohol use disorder" 13 : 76-80, 2012

13 Shelmet JJ, "Ethanol causes acute inhibition of carbohydrate, fat, and protein oxidation and insulin resistance" 81 : 1137-1145, 1988

14 Dornhorst A, "Effect of alcohol on glucose tolerance" 2 : 957-959, 1971

15 Rehm J, "Alcohol as a risk factor for global burden of disease" 9 : 157-164, 2003