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Abstract Details

Who Do You Order Drug Screening For?: The Relationship Between Race and Urine Drug Screens in Patients with Altered Mental Status or Encephalopathy in the Emergency Department
Health Care Disparities
P6 - Poster Session 6 (5:30 PM-6:30 PM)
4-010
Many patients visit the ED for AMS and encephalopathy, and urine drug screens (UDS) are often obtained to evaluate for substance use as an etiology. In our review of literature, there are no studies investigating racial differences in UDS performance for patients with AMS or encephalopathy in the ED.
To determine the relationship between race and urine drug screen (UDS) ordering in patients evaluated in the Emergency Department (ED) with altered mental status (AMS) or encephalopathy.
A retrospective review of patients ≥18 years of age diagnosed with AMS or encephalopathy in the ED between January 25, 2022 and December 31, 2021 was conducted. The relationship between race and ordering of UDS was explored using the Chi-square or Fisher’s Exact test. Significance was assessed at p<0.05.
The review included 293 patients, average age 58.5+20.9 years with 52.6% (154) males and 47.4% (139) females. UDS were ordered more frequently for Hispanics (50.0%; 8/16) and African-Americans (46.6%; 34/73) compared to Caucasians (34.3%; 68/198) though not a significant finding (p=0.093). Overall, there was no significant difference in the percentage of positive UDS results among racial groups: Hispanic (66.7%; 4/6), African-American (60%; 15/25), and Caucasian (52.8%; 28/53), p=0.726. Among the individuals who did not have a history of substance use, there was a significant difference with UDS being ordered more frequently for Hispanic (50.0%; 3/6) and African-American (44.7%; 21/47) groups compared to Caucasian (23.1%; 34/147), Asian (0.0%; 0/4), and American-Indian or Alaskan Native (0.0%, 0/2) patients (p=0.014).
Our single-institution study revealed disproportionate UDS ordering among races. Further exploration into racial disparities in obtaining UDS for patients presenting to the ED with AMS or encephalopathy is warranted.
Authors/Disclosures
Sojung K. Park, DO (Trinity Health Grand Rapids)
PRESENTER
Dr. Park has nothing to disclose.
No disclosure on file
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
Aileen Antonio, MD, FAAN (Trinity Health Saint Mary's Hauenstein Neurosciences) Dr. Antonio has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. Dr. Antonio has received research support from AAN PALF. The institution of Dr. Antonio has received research support from Trinity Health Foundation. The institution of Dr. Antonio has received research support from AAN IDEAS Grant. The institution of Dr. Antonio has received research support from Saint Mary's Foundation. The institution of Dr. Antonio has received research support from Saint Mary's Foundation . The institution of Dr. Antonio has received research support from Saint Mary's Foundation.