Schermer Carol R, Moyers Theresa B, Miller William R, Bloomfield Lori A
Department of Surgery, University of North Carolina, Chapel Hill, NC 27599, USA.
J Trauma. 2006 Jan;60(1):29-34. doi: 10.1097/01.ta.0000199420.12322.5d.
A substantial number of trauma center admissions are related to driving under the influence (DUI); however, there has been no prior report of brief intervention (BI) after injury reducing subsequent DUI arrests. The hypothesis of this study was that injured patients receiving BI would have a lower risk of DUI arrest within 3 years of discharge than those receiving standard care (SC).
This prospective, randomized clinical trial randomly allocated patients involved in motor vehicle collisions to receive SC or a BI regarding alcohol use. The primary outcome measure was DUI arrest within 3 years of hospital discharge. DUI arrests were documented by matching demographic information to state traffic safety data.
After randomization (N = 126), BI and SC groups were similar in age, prior DUI arrests, and alcohol screening score. BI sessions lasted an average of 30 minutes and were performed by either a social worker or a trauma surgeon. Approximately one in six participants (n = 21, 16.7%) had a DUI arrest within 3 years of hospital discharge. Within 3 years of hospital discharge, 14 of 64 patients (21.9%) in the SC group had an arrest for DUI compared with only 7 of 62 patients (11.3%) who received the BI. Multivariate analysis demonstrated that BI was the strongest protective factor against DUI arrest (odds ratio [OR], 0.32; 95% confidence interval < or =CI], 0.11-0.96). Prior number of DUIs (OR, 1.43; 95% CI, 1.03-2.01) and age (OR, 0.94; 95% CI, 0.88-0.99) were also associated with DUI arrest post-hospitalization, but alcohol screening score (OR, 1.06; 95% CI, 0.99-1.13) was not. The absolute risk reduction implies that only nine patients would need to receive a BI to prevent one DUI arrest.
Patients who receive BI during a trauma center admission are less likely to be arrested for DUI within 3 years of discharge. BI represents a viable intervention to reduce DUI after trauma center admission.
大量创伤中心收治的患者与酒后驾车（DUI）有关；然而，此前尚无关于受伤后进行简短干预（BI）可减少后续DUI被捕的报告。本研究的假设是，与接受标准护理（SC）的患者相比，接受BI的受伤患者出院后3年内DUI被捕的风险更低。
这项前瞻性随机临床试验将机动车碰撞事故患者随机分配接受SC或关于饮酒的BI。主要结局指标是出院后3年内DUI被捕情况。通过将人口统计学信息与州交通安全数据匹配来记录DUI被捕情况。
随机分组后（N = 126），BI组和SC组在年龄、既往DUI被捕情况和酒精筛查评分方面相似。BI疗程平均持续30分钟，由社会工作者或创伤外科医生进行。约六分之一的参与者（n = 21，16.7%）在出院后3年内有DUI被捕记录。出院后3年内，SC组64例患者中有14例（21.9%）因DUI被捕，而接受BI的62例患者中只有7例（11.3%）。多变量分析表明，BI是预防DUI被捕的最强保护因素（优势比[OR]，0.32；95%置信区间[CI]，0.11 - 0.96）。既往DUI次数（OR，1.43；95% CI，1.03 - 2.01）和年龄（OR，0.94；95% CI，0.88 - 0.99）也与出院后DUI被捕有关，但酒精筛查评分（OR，1.06；95% CI，0.99 - 1.13）无关。绝对风险降低意味着仅需9例患者接受BI即可预防1例DUI被捕。
在创伤中心住院期间接受BI的患者出院后3年内因DUI被捕的可能性较小。BI是创伤中心住院后减少DUI的一种可行干预措施。
