Abstract
BackgroundAlcohol plays a significant role in major traumatic injuries. While the role of alcohol in motor vehicle trauma (MVT) is well described, its role and approaches to prevention in other injury mechanisms is less defined.MethodsA 10 year retrospective examination of Alberta Trauma Registry (ATR) data was conducted on all major trauma patients (age ≥ 9 and ISS ≥ 12) from 2001–2010. The role and prevalence of alcohol is examined.ResultsOf 22,457 patients included in our study, only 60 %(n = 13,552) were screened for alcohol use. Of those screened, 38 %(n = 5,170) tested positive for alcohol with a mean blood alcohol concentration (BAC) of 39.4 ± 21.1 mmol/L. Of the positive screening tests, 82.3 % had BAC levels greater than the common legal driving limit of 17.4 mmol/L (0.08 %). Testing positive was associated with male gender (p < 0.001) and younger age (p < 0.001). The rate of positive alcohol use in major trauma increased from 20.3 % in 2001 to 24.3 % in 2010, corresponding with a screening rate increase from 51.3 % to 61.2 % over the same period. Railway incidents have the highest rate of alcohol involvement (65 %), followed by undetermined-if-accidental/self-inflicted (53.5 %) and assault (49 %); motor vehicle traffic (MVT) incidents had a frequency of 25.4 %.ConclusionsThe prevalence of alcohol use in major trauma appears to be increasing in Alberta but the true extent is still underappreciated. Furthermore, the role of alcohol in non-MVT injuries is significant and deserves further attention. The vast majority of patients involved in alcohol-related trauma are legally intoxicated. Alcohol use continues to be a substantial contributor to major trauma in Alberta, and represents an important opportunity to reduce preventable injuries.
Highlights
Alcohol plays a significant role in major traumatic injuries
Studies published in the early 1990s demonstrated that approximately 40 % of patients admitted to trauma centres had alcohol use as the precipitating factor leading to acute injury [11], with a significant prevalence of substance abuse disorders reported in this population [12]
Data was obtained from the Alberta Trauma Registry (ATR), which is housed at the Alberta Centre for Injury Control and Research (ACICR)
Summary
Alcohol plays a significant role in major traumatic injuries. Alcohol abuse is a major contributing factor in many types of injuries. While the issues surrounding “drinking and driving” tend to be well-recognized and publicized, the contribution of alcohol to other causes of traumatic injury is, in general, under-recognized and underappreciated. Studies published in the early 1990s demonstrated that approximately 40 % of patients admitted to trauma centres had alcohol use as the precipitating factor leading to acute injury [11], with a significant prevalence of substance abuse disorders reported in this population [12]. More recent studies have demonstrated alcohol use to be a significant risk factor for various injury types ranging from falls to interpersonal violence to recreational vehicle use [13,14,15]
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