Each year, intoxicated patients are admitted to the emergency units (EU) in Poland. For most of them this is a one-time situation, however there is also a group of patients for whom it is an established part of life (1, 2). These patients most often are brought in by Medical Rescue Teams, who are dispatched to a patient under the influence of alcohol or other drugs (3, 4). In Poland, there is still a lack of clear legal regulations that would comprehensively describe the rules of hospitalization of intoxicated people. The hospital and mostly all of the Emergency Department personnel (mainly an admitting doctor) cannot refuse hospitalization of an intoxicated person, who is brought in by the police or the Medical Rescue Team, until they carry out a basic diagnosis which will allow for ruling out the immediate life threatening condition of said person. Personnel and people who work in the hospitals are more and more often becoming victims of aggression while performing examination of this kind of special patient (5). Knowing that the patient is drunk with alcohol does not release the personnel from the proper examination of the patient, carrying out the tests or the necessary diagnosis and obliges to pay special attention, because especially in mental disorders, it is difficult to unambiguously assess whether there is an underlying mental illness requiring hospitalization or the behavior is the result of excessive alcohol consumption (6, 7). It should also be noted that, when a patient is admitted in the EU, the doctor or the coordinator of the triage may decide on the use of so-called “use of force”, which means that such patients might be hospitalized without their consent. This regulation applies to the people who: pose a threat to themselves, others or public safety, violently damage objects in their surroundings or interrupt with the functioning of the hospital (8, 9). When an intoxicated person shows such symptoms, the doctor should not only decide to not refuse the admission, but first and foremost should determine whether these symptoms are the result of a mental illness or abuse of alcohol alone (6, 10). Acting according to the rules of examination and diagnosis of the patient will ensure his safety, however we cannot forget about ensuring the safety of the personnel who works in the hospital (11). The number of intoxicated patients who are admitted to EU is growing and changes depending on the place and days of the week. The majority of alcohol intoxicated patients are treated within EU around the weekend days and in the large cities. Intoxicated patients account for over 10% of all patients admitted to the EU.

The aim of our study was the assessment of intoxicated patients who were treated in the Emergency Unit of Child Jesus Clinical Hospital in Warsaw in 2013.

This study was based on the retrospective analysis of medical records of the patients who were admitted to the EU of the Child Jesus Clinical Hospital in Warsaw. After gaining the approval of ethics board of Warsaw Medical University and the approval of the Hospital Management the analysis of intoxicated patients, who were admitted to the EU of this hospital from 1^st January 2013 until 31^st December 2013, was performed.

We assessed the following variables: sex, age, hour and day of the admission to the EU, reason for hospitalization, degree and level of injuries, mechanism of injury, comparison of Glasgow Coma Scale based on the records from Medical Rescue Teams as well as further procedures with the patient. Additionally, an analysis of the costs of treatment of intoxicated patients per capita was performed.

The study included 624 intoxicated patients who received treatment in the EU. Among women the largest group was aged 17-30, which amounted for 48.51%. For men the largest group was in the age of 31-51, which amounted for 49.16%.

There was a statistically significant correlation between the amount of alcohol in the body and the GCS score (R = -0.339; P < 0.001) (fig. 1). There were no statistically significant differences between amount of alcohol and occurrence of injuries (2.77 ± 1.28 vs. 2.75 ± 1.03‰; P = 0.768) (fig. 2). The study revealed a high statistical significance between a probability of traumatic patient and blood alcohol content. Among the traumatic men, 36.94% were people whose blood alcohol content was between two and three promil. The non-traumatic patients with the same amount blood alcohol content accounted for 25.81%. The blood alcohol content ranging from three and four promil accounted for 32.8% of non-traumatic patients and 23.83% of traumatic patients. The total number of trauma patients is 333 and not-traumatic is 186. Among women, the results are evenly distributed and do not show statistically significant variability. Among the most common diagnoses within analyzed patients were: blunt head trauma (30.8%), alcohol poisoning (22.7%), cut wounds of the head (17.2%). A detailed list of diagnoses within the analyzed group is shown in figure 3.

In the analyzed group of patients, no statistically significant differences were found between a GCS score and occurrence of injuries (14 ± 2 vs. 14 ± 2; P = 0.939) (fig. 4). A vast majority of patients without insurance are found in the age group of 31-55. 52.36% of all uninsured patients are found in this age group. Among men the age group 31-55 was the largest and amounted for around 50% of all men.

There were statistically significant differences between amount of alcohol in the body and having insurance (2.57 ± 1.07 vs. 2.97 ± 1.16‰; P < 0.001) (fig. 5).