Emergency department admissions Kumasi, Ghana: Prevalence of alcohol and substance use, and associated trauma

Introduction: Alcohol and substance use (ASU) are significant contributors to global morbidity, mortality, and health resource utilization. We sought to describe the frequency of ASU use among adult injured patients presenting to the Komfo Anokye Teaching Hospital Emergency Department (KATH ED) and to describe injury mechanism and site among injured patients. Methods: A cross-sectional study was carried out for six months in 2016 involving all trauma patients and altered mental status patients presenting to the ED in Kumasi, Ghana. Blood alcohol concentration was evaluated with SureScreen Alcometer Breathalyzer, which provided a numeric breath alcohol concentration in mg/L units (BAC). Substance presence was evaluated using saliva strips with Micro-Distribution STATSWAB 6 panel oral fluid devices. Medical charts were reviewed retrospectively for details of history after testing was done at triage. Results: The total number of patients tested for substance use was 171 comprising 146 trauma patients and 25 non-trauma patients with altered mental statuses. Twenty–four percent (41) of patients tested positive for drugs. Of these 41, 29 tested positive for marijuana, six tested for opiates, two tested for oxycodone, two tested positive for cocaine, one tested positive for benzodiazepines, and one tested positive for methamphetamines. About a third (29%) of the patients tested positive for alcohol. Eleven patients (6.4%) tested positive for ASU. Road traffic injuries were the commonest mechanism of injury. Lower limb (42.1%), upper limb (29.2%), and head injuries constituted the most common injuries. Conclusion: ASU may be a preventable cause of injuries among adults presenting to KATH ED.