PubMed Health⌕ Search

Biomedical subjects

Grazyna Swiatkiewicz

Publications and source records attributed to Grazyna Swiatkiewicz.

8 recordsLinked to original sources
PubMed2006

Acute alcohol use and the risk of non-fatal injury in sixteen countries.

AIMS: To determine the relative risk (RR) of non-fatal injury associated with alcohol consumption in a series of emergency departments (EDs), possible effect modifiers and the impact of contextual variables on differences across sites. DESIGN: The case-crossover method was used to obtain RR estimates of the effect of alcohol on non-fatal injuries. Meta-analysis was used to evaluate the consistency and magnitude of RR across sites, and the extent to which contextual variables explain differences in effect sizes. PARTICIPANTS: Probability samples of 11,536 injured patients attending 28 EDs studies in 16 countries (1984-2002). The majority of the sample was male (65%) and > 30 years old (53%). MEASUREMENTS: Exposed cases where those that consumed alcohol 6 hours prior to the injury. Usual alcohol consumption served as the control period. FINDINGS: Drinking within 6 hours prior to the injury was reported by 21% of the sample. The estimated (random) pooled relative risk for patients who reported alcohol use within 6 hours prior to injury was 5.69 (95% confidence interval = 4.04-8.00), ranging from 1.05 in Canada to 35.00 in South Africa. Effect size was not homogeneous across studies, as societies with riskier consumption patterns had a higher relative risk for injury. Heavier drinkers also showed lower RR. CONCLUSIONS: Acute alcohol was a risk factor for non-fatal injuries in most sites. Policy measures addressed to the general population are recommended, especially in societies with riskier consumption patterns.

Adult↗
PubMed2006

Results of two emergency room studies.

The aim of this paper is to examine to what extent cultural differences in male drinking patterns mediate relationships between alcohol and injury in a Polish context. Male patients admitted to emergency rooms located in two culturally different regions were investigated. Data analysis showed significant differences in patients' socio-demographic characteristics, their drinking patterns as well as their annual alcohol consumption. Logistic regression, however, has not confirmed any impact of site, drinking pattern and their interactions on the risk of injury. The risk of injury tended to decline with age, being more than two times lower for men over 50 years old, and was 2.4 times higher for those with an annual consumption of 12+ liters of pure alcohol.

Adult↗
PubMed2006

The effect of alcohol consumption on emergency department services use among injured patients: A cross-national emergency room study.

OBJECTIVE: Although injured patients in the emergency department (ED) report more frequent use of the ED compared with the general population, and alcohol-related admissions and chronic alcohol misuse have been found to be predictive of future ED admissions, these data are based on only a few U.S. studies. The purpose of this article was to explore the association of alcohol use and ED services use among injured patients cross-nationally. METHOD: Binary and multinomial logistic regression were used to analyze the association of alcohol consumption with prior ED visits among 9,743 injured patients surveyed in 37 EDs in 14 countries and reported in 23 studies from the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and World Health Organization Collaborative Study of Alcohol and Injuries. RESULTS: Drinking within 6 hours before injury was associated with prior ED visits during the last 12 months (odds ratio = 1.25, p < .05), with a positive dose-response relationship. Heavy drinkers and those drinkers who were alcohol-dependent were also significantly more likely to report multiple prior ED visits, reflecting an elevated burden of services use. At the ED level, stigmatization of alcohol use was the only significant contextual variable that consistently predicted cross-ED variation in the relationship between drinking and ED use, in which the association was weaker in areas where alcohol use is less accepted. CONCLUSIONS: This study lends additional support to the potential effectiveness of screening for acute and chronic alcohol use among ED injured patients to reduce ED services use and associated costs.

Adolescent↗
PubMed2005

Screening for alcohol problems in two emergency service samples in Poland: comparison of the RAPS4, CAGE and AUDIT.

Prior research on alcohol-related problems among emergency service patients in Poland found substantial alcohol involvement on the part of injured males, suggesting emergency services may be a productive venue for identifying patients who could benefit from a brief intervention or referral for treatment. Performance of the RAPS4, CAGE and AUDIT against ICD-10 and DSM-IV criteria for alcohol dependence and for alcohol abuse/harmful drinking was compared in probability samples of emergency service patients from two regions of Poland. Sensitivity of the RAPS4 and AUDIT was significantly better than the CAGE for alcohol dependence among males in Warsaw, but specificity was poorer. Among females, although numbers were small, sensitivity for alcohol abuse/harmful drinking and for alcohol dependence or abuse/harmful drinking was significantly better for the RAPS4-QF than for the CAGE or AUDIT at a cut point of 8 across both sites. Performance of the AUDIT at a cut point of 3 was similar to the RAPS4-QF for females. Among males, sensitivity was higher but specificity considerably lower for the RAPS4-QF compared to the CAGE at a cut point of 1 or for the AUDIT at a cut point of 8. Alternate cut points for the AUDIT optimized performance. Findings suggest some regional and gender differences in performance of screening instruments in these Polish samples, but no instrument or cut point is optimal in identifying those with alcohol use disorders. Additional cross-cultural research is needed to evaluate the performance of instruments, especially among females with alcohol use disorders.

Adolescent↗
PubMed2005

Risk of injury: a case-crossover analysis of injured emergency service patients in poland.

BACKGROUND: Over the last 15 years large changes in both alcohol consumption and the health care system have occurred in Poland. Substantial fluctuations in alcohol-related mortality followed and burden on health services increased, but data on risk of injury from alcohol consumption are relatively scarce METHODS: Estimates for risk of injury from drinking within six hours prior to the event are reported in samples of emergency services patients from Warsaw (n=508) and Sosnowiec (n=432), using case-crossover analysis based on usual frequency of drinking RESULTS: A four-fold risk of injury was found for those reporting drinking prior to injury compared to those not drinking, and this was significantly greater for those positive for alcohol use disorders compared to those negative. Relative risk of injury was marginally greater in Sosnowiec (5.2) compared to Warsaw (3.4) (p=0.06), and was significantly greater for those under 30. A 17-fold increase in risk for violence-related injury was found, and was significantly greater for females than males. Risk was substantially greater in Sosnowiec compared to Warsaw across all subgroups, but differences were not significant, possibly due to the small numbers of those sustaining injuries from violence in Warsaw. DISCUSSION: Injury risk related to drinking was expected to be significantly greater in Sosnowiec, due to more traditional drinking styles of infrequent intake of large quantities of spirits, than in Warsaw, but this was only partially borne out by these data. Risk estimates for all injuries were similar to those found in other case-crossover studies in emergency departments. Given the high relative risk estimates for injury related to drinking prior to the event, among both problem and non-problem drinkers, hospital-based emergency services in Poland may be an important site for identification of those who could benefit from a brief intervention or referral for a reduction in alcohol-related injuries.

Adult↗
PubMed2005

Cross-national performance of the RAPS4/RAPS4-QF for tolerance and heavy drinking: data from 13 countries.

OBJECTIVE: There are little data available on the performance of brief screening instruments for alcohol-use disorders cross-nationally; therefore, we analyzed the performance of one such instrument in a number of countries. METHOD: Performance of the RAPS4 for tolerance and the RAPS4-QF for heavy drinking are analyzed from emergency room data across 13 countries included in the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injuries. RESULTS: The RAPS4 showed good sensitivity and specificity for tolerance across most of the countries, but was higher in countries that were higher on societal-level detrimental drinking patterns. Prevalence of tolerance was also higher in those countries with high detrimental drinking pattern scores. Sensitivity of the RAPS4-QF for heavy drinking was uniformly high across countries, while maintaining good specificity, and did not vary by detrimental drinking patterns. CONCLUSIONS: Findings suggest the RAPS4 and RAPS4-QF may hold promise cross-nationally. Future research should more fully address the performance of brief screening instruments for alcohol-use disorders (using standard diagnostic criteria) cross-nationally, with consideration of the impact of societal drinking patterns.

Alcoholism↗
PubMedDate not supplied

Drinking patterns and problems in emergency services in Poland.

AIMS: To examine drinking patterns and problems in emergency services in Poland, where both alcohol consumption and the health care system have undergone enormous recent change. METHODS: A probability sample of 734 emergency service patients was breathalyzed and interviewed in a large public hospital in Warsaw, Poland. RESULTS: 2.5% of the sample was breathalyzer positive; all were male and injured. Injured males were significantly more likely to report heavy problem drinking than non-injured, but no differences were found for females. Among injured males who reported drinking prior to the event, close to 50% reported feeling drunk, and over 75% attributed a causal association of their drinking with injury. CONCLUSIONS: These data point to substantial alcohol-involvement on the part of injured males in this population, and suggest emergency services may be a productive venue for identifying those patients who would benefit from a brief intervention.

Adolescent↗