Factors associated with 30-day drug-related emergency department re-attendance among methamphetamine users: a territory-wide retrospective study in Hong Kong

Comprehensive Summary

Chan et al., conducted a retrospective cohort study of 815 cases of acute methamphetamine toxicity to identify risk factors for 30-day drug-related ED re-attendance after hospital discharge. Data were drawn from the Hong Kong Poison Control Center (2010-2019), which receives reports from all 18 public EDs in the city. Drug-related re-attendance was defined as any drug presentation linked to drug use sequelae. Within 30 days, 131 patients (16.1%) re-attended for drug-related problems, with methamphetamine implicated in 90.8%. On univariate analysis, several factors were linked to higher re-attendance risk, including social allowance, psychiatric comorbidities ( psychosis, antisocial personality disorder, schizophrenia), prior failed detoxification, and a history of drug misuse. Neither psychosocial interventions at the index visit nor the severity of acute toxicity predicted re-attendance. The authors noted that most identified risk factors are not readily modifiable in the ED setting. They referenced prior evidence that multidisciplinary models with a single point of contact, such as case managers, can reduce ED utilization.

Outcomes and Implications

Risk factors for short-term ED re-attendance among methamphetamine users are poorly characterized in existing literature. The findings underscore the need for public health strategies and care models, particularly case manager-led approaches, to better support this high-risk population.