Abstract
BackgroundAlcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients.MethodsThis is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center.ResultsA total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8–19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005).ConclusionsFindings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted.
Highlights
Alcohol abuse is recognized as a significant contributor to injury
While the trained research personnel implemented computerized screening and brief intervention (SBI) using a touchscreen tablet computer on all designated trauma patients admitted to the hospital in the level 1 trauma center, nurses were responsible to perform this screening in the level 2 trauma center
Patient enrollment Overall, 4,282 and 1,998 admitted trauma patients at the level 1 and 2 trauma centers were screened using the computerized SBI during the day until midnight
Summary
Alcohol abuse is recognized as a significant contributor to injury. It is essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients. Excessive alcohol consumption is a risk factor for many health and societal problems. It accounts for the third leading cause of death in the United States, which is preventable [1]. According to the Centers for Disease Control and Prevention (CDC), almost 30 people die each day in motor vehicle crashes that involve an alcohol-impaired driver in the United States. This is almost one death every 51 min [2]. Almost $59 billion is spent annually on alcohol-related crashes [4]
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