Large study links alcohol misuse to subsequent injury risk in young people

The immediate effects of drinking too much alcohol are obvious, unpleasant and can even be life threatening, but a new study has shown that young people who drink excessively, to the degree that they are admitted into hospital because of it, are also at a much higher risk of sustaining injuries in the following 6 months.

The study by researchers in the University of Nottingham's School of Medicine, funded by the NIHR, found that young people who are admitted into hospital in England because of alcohol are seven times more likely to have an injury that needs a hospital stay in the 6 months after the alcohol-related admission and 15 times more likely to end up in hospital through injury in the first month after the alcohol admission.

It's the first time the detailed epidemiology of the association between heavy drinking in adolescence and subsequent injury risk after a hospital admission has been described. The NIHR-funded research, published in the Journal of Adolescent Health, calls for more to be done to raise awareness of this strong link among both young people and among health professionals.

The researchers looked at the primary care medical records and hospital admission records of around 120,000 young people aged between 10 and 24 in the 15 year period between 1998 and 2013. Of those, just over 11,000 had been admitted to hospital because of alcohol and the rest had not. 18.9% of the alcohol admission cohort were subsequently admitted to hospital for an injury during the study follow-up period compared to just 2.6% of the others. The most common type of injury was poisoning (e.g.intentional self poisoning ), inanimate mechanical forces (e.g.struck by a falling object) and animate forces (e.g.hit by another person).

Public Health Registrar, Louise Lester, from the University's Division of Primary Care, said: "We know that dangerous and harmful drinking is on the rise in young people but this is the first detailed evidence of an association between injury risk in individuals after their alcohol-related hospital admission. We've shown that this risk varies by age, sex and socio-ecomomic factors over time and the results will be very valuable to future research to find out why these young people are more likely to sustain serious injuries in the months and even years after their alcohol incident. Interestingly we found this increased risk was highest in females, 17 to 24 year olds and those in the most deprived quintile of the cohort."

Dr Elizabeth Orton, Public Health Consultant and Associate Professor at the University, said: "Our study raises a red flag for public health research and we hope will lead to better public and professional awareness of the potential subsequent injury risk of alcohol misuse in young people. Current interventions focus on drinking habits rather than preventing specific outcomes related to alcohol. If a young person ends up in hospital because of alcohol there is a good opportunity for health professionals to discuss their drinking behaviour and give them brief advice. This new data will allow the advice to be specifically tailored and include injury prevention to increase the effectiveness of the support offered to young people who find themselves in hospital because of alcohol."

More research is needed to examine the reasons why the injury risk is so much greater for those admitted to hospital through drinking. In the meantime the researchers say that with the greatest risk of injury in the first month after discharge, evidence-based primary and secondary injury prevention and harm reduction programmes should be implemented by health care providers.