Roudsari Bahman, Caetano Raul, Frankowski Ralph, Field Craig
University of Texas School of Public Health, Dallas, TX, USA.
Ann Emerg Med. 2009 Aug;54(2):285-93. doi: 10.1016/j.annemergmed.2009.01.033. Epub 2009 Feb 28.
The current study evaluates whether the effectiveness of brief alcohol intervention in reducing 6- and 12-month risk of injuries in a large Level I urban trauma center varies according to trauma patients' ethnicity.
Eligible white, Hispanic, and black trauma patients aged 18 years or older were randomized to brief alcohol intervention or treatment as usual. The intervention was a "non-confrontational, patient-centered conversation" focused on patients' drinking pattern, with the purpose of encouraging them to change risky drinking. Study outcomes were patient-reported 6- and 12-month incidence of all-type injuries, alcohol-related injuries, and serious injuries (ie, injuries requiring emergency department visit or hospital admission).
A total of 1,493 trauma patients (668 whites, 537 Hispanics, 288 blacks) participated in this study. After 1 year of follow-up, we were not able to detect any important association between brief intervention and the risk of all-type injuries, alcohol-related injuries, or serious injuries among study participants. In addition, the association between brief intervention and the outcomes of interest was not modified by patients' ethnicity.
Our study, congruent with some recent publications, implies that there are some patient- and provider-related impediments that could restrict the effectiveness of brief intervention programs in trauma centers, regardless of patient ethnicity. Unless those impediments are identified and eliminated, assuming that brief intervention will be an effective strategy for controlling future alcohol-related injuries among trauma patients and should be provided under any circumstances might not be reasonable.
本研究评估在一家大型一级城市创伤中心,简短酒精干预在降低6个月和12个月创伤风险方面的有效性是否因创伤患者的种族而有所不同。
年龄在18岁及以上的符合条件的白人、西班牙裔和黑人创伤患者被随机分为简短酒精干预组或常规治疗组。干预是一次“非对抗性、以患者为中心的谈话”,聚焦于患者的饮酒模式,目的是鼓励他们改变危险饮酒行为。研究结果是患者报告的6个月和12个月内各类损伤、酒精相关损伤以及重伤(即需要急诊就诊或住院治疗的损伤)的发生率。
共有1493名创伤患者(668名白人、537名西班牙裔、288名黑人)参与了本研究。经过1年的随访,我们未能发现简短干预与研究参与者中各类损伤、酒精相关损伤或重伤风险之间存在任何重要关联。此外,简短干预与感兴趣的结果之间的关联并未因患者的种族而改变。
我们的研究与近期的一些出版物一致,表明存在一些与患者和提供者相关的障碍,可能会限制创伤中心简短干预项目的有效性,无论患者种族如何。除非识别并消除这些障碍,否则假设简短干预将是控制创伤患者未来酒精相关损伤的有效策略,并且在任何情况下都应提供,可能是不合理的。