Medical University of South Carolina, Center for Drug and Alcohol Programs, Charleston, SC.
West J Emerg Med. 2010 May;11(2):133-7.
Brief alcohol intervention may improve outcomes for injury patients with hazardous drinking but is less effective with increased severity of alcohol involvement. This study evaluated a brief method for detecting problem drinking in minor trauma patients and differentiating hazardous drinkers from those with more severe alcohol problems.
Subjects included 60 minor trauma patients in an academic urban emergency department (ED) who had consumed any amount of alcohol in the prior month. Screening and risk stratification involved the use of a heavy-drinking-day screening item and the Rapid Alcohol Problems Screen (RAPS). We compared the heavy-drinking-day item to past-month alcohol use, as obtained by validated self-reporting methods, and measured the percentage of carbohydrate-deficient transferrin (%CDT) to assess the accuracy of self-reporting. The Alcohol Dependence Scale (ADS) was administered to gauge the severity of alcohol involvement and compared to the RAPS.
Eighty percent of the subjects endorsed at least one heavy drinking day in the past year, and all patients who exceeded recommended weekly drinking limits endorsed at least one heavy drinking day. Among those with at least one heavy drinking day, 58% had a positive RAPS result. Persons with no heavy drinking days (n=12) had a median ADS of 0.5 (range 0 to 3). RAPS-negative persons with heavy drinking days (n=20) had a median ADS of 2 (range 0 to 8). RAPS-positive persons with heavy drinking days (n=28) had a median ADS of 8 (range 1 to 43).
A heavy-drinking-day item is useful for detecting hazardous drinking patterns, and the RAPS is useful for differentiating more problematic drinkers who may benefit from referral from those more likely to respond to a brief intervention. This represents a time-sensitive approach for risk-stratifying non-abstinent injury patients prior to ED discharge.
简短的酒精干预可能会改善有危险饮酒行为的创伤患者的预后，但对于酒精摄入程度加重的患者效果较差。本研究评估了一种在轻微创伤患者中检测饮酒问题并区分危险饮酒者和更严重酒精问题患者的简短方法。
本研究纳入了在学术性城市急诊部（ED）接受治疗的 60 名有轻微创伤且过去一个月内有饮酒行为的患者。筛选和风险分层包括使用大量饮酒日筛查项目和快速酒精问题筛查（RAPS）。我们将大量饮酒日项目与过去一个月的饮酒情况进行比较，这些信息通过经过验证的自我报告方法获得，并测量转铁蛋白缺乏率（%CDT）以评估自我报告的准确性。还使用酒精依赖量表（ADS）来评估酒精摄入程度，并与 RAPS 进行比较。
80%的受试者在过去一年中至少有一天饮酒过量，所有超过推荐每周饮酒量的患者都至少有一天饮酒过量。在有至少一天饮酒过量的患者中，有 58%的患者 RAPS 检测结果呈阳性。没有饮酒过量日的患者（n=12）的 ADS 中位数为 0.5（范围 0 至 3）。有饮酒过量日但 RAPS 检测结果为阴性的患者（n=20）的 ADS 中位数为 2（范围 0 至 8）。有饮酒过量日且 RAPS 检测结果为阳性的患者（n=28）的 ADS 中位数为 8（范围 1 至 43）。
大量饮酒日项目可用于检测危险饮酒模式，RAPS 可用于区分更有问题的饮酒者，这些患者可能需要转介，而不太可能对简短干预产生反应。这代表了一种在 ED 出院前对非戒酒的创伤患者进行风险分层的敏感方法。
