使用国家酒精滥用和酒精中毒研究所建议的筛查方法和新开发的工具，在外科患者中检测不健康的饮酒者。

Use of the screening suggested by the National Institute on Alcohol Abuse and Alcoholism and of a newly derived tool for the detection of unhealthy alcohol drinkers among surgical patients.

机构信息

Bernard B Brodie Department of Neuroscience, University of Cagliari, Monserrato, CA, Italy.

出版信息

J Stud Alcohol Drugs. 2012 Jan;73(1):126-33. doi: 10.15288/jsad.2012.73.126.

DOI:10.15288/jsad.2012.73.126

PMID:22152670

Abstract

OBJECTIVE

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed a two-question tool for the detection of unhealthy drinking (NIAAA-2Q) that investigates excessive alcohol consumption per single occasion. NIAAA-2Q can be commuted into a four-question tool (NIAAA-4Q) by the addition of two questions aimed at investigating excessive weekly alcohol intake. NIAAA-2Q and NIAAA-4Q may prove useful in busy settings such as an anesthesiological environment. However, to date, no study has evaluated their efficacy in a surgical setting. The purpose of this study was to evaluate the accuracy of NIAAA-2Q and NIAAA-4Q in detecting unhealthy drinking among surgical patients using the more complex Alcohol Use Disorders Identification Test (AUDIT) comprising 10 questions as the criterion method.

METHOD

NIAAA-4Q and AUDIT were administered to 200 surgical patients by three anesthetists.

RESULTS

A total of 23.5%, 12.5%, and 28.5% surgical patients were unhealthy drinkers according to AUDIT, NIAAA-2Q, and NIAAA-4Q, respectively. NIAAA-2Q negative and positive predictive values were 0.78 and 0.36, respectively, and positive and negative likelihood ratios were 1.80 and 0.90, respectively. NIAAA-4Q negative and positive predictive values were 0.93 and 0.65, respectively, and positive and negative likelihood ratios were 6.00 and 0.24, respectively.

CONCLUSIONS

NIAAA-4Q demonstrated a better satisfactory agreement than NIAAA-2Q with AUDIT in detecting unhealthy alcohol drinking among surgical patients. These results suggest that the detection of unhealthy alcohol drinking may be increased by the administration of questions aimed at assessing the weekly average of alcohol intake. The modest time required for NIAAA-4Q administration is a major advantage in clinical practice with respect to AUDIT. Further research will compare NIAAA-2Q and NIAAA-4Q with other brief alcohol screening tests.

摘要

目的

美国国家酒精滥用与酒精中毒研究所（NIAAA）开发了一种用于检测不健康饮酒的两问题工具（NIAAA-2Q），该工具调查单次过量饮酒情况。通过添加两个旨在调查每周过量饮酒的问题，NIAAA-2Q 可以转换为四问题工具（NIAAA-4Q）。NIAAA-2Q 和 NIAAA-4Q 在繁忙的环境中可能非常有用，例如麻醉环境。然而，迄今为止，尚无研究评估其在手术环境中的效果。本研究旨在使用更复杂的包含 10 个问题的酒精使用障碍识别测试（AUDIT）作为标准方法，评估 NIAAA-2Q 和 NIAAA-4Q 在检测手术患者中不健康饮酒的准确性。

方法

由三位麻醉师向 200 名手术患者进行 NIAAA-4Q 和 AUDIT 测试。

结果

根据 AUDIT，23.5%、12.5%和 28.5%的手术患者为不健康饮酒者，分别根据 NIAAA-2Q 和 NIAAA-4Q。NIAAA-2Q 的阴性和阳性预测值分别为 0.78 和 0.36，阳性和阴性似然比分别为 1.80 和 0.90。NIAAA-4Q 的阴性和阳性预测值分别为 0.93 和 0.65，阳性和阴性似然比分别为 6.00 和 0.24。

结论

与 AUDIT 相比，NIAAA-4Q 在检测手术患者的不健康饮酒方面表现出更好的一致性。这些结果表明，通过询问评估每周平均饮酒量的问题，可以提高对不健康饮酒的检测。NIAAA-4Q 所需的时间适中，在临床实践中相对于 AUDIT 具有很大优势。未来的研究将比较 NIAAA-2Q 和 NIAAA-4Q 与其他简短的酒精筛查测试。