Trauma Services, Dell Children’s Medical Center of Central Texas, Austin, Texas 78723, USA. ka
Pediatrics. 2012 Jul;130(1):115-22. doi: 10.1542/peds.2011-1589. Epub 2012 Jun 4.
Alcohol use by adolescents is widespread and is connected to a number of negative health and social outcomes. Adolescents receiving emergent care for injuries are often linked with risky use of alcohol. The trauma system has widely adopted the use of screening, brief intervention, and referral to treatment (SBIRT) for preventing alcohol-related injury recidivism and other negative outcomes. The purpose of this article is to review the evidence around SBIRT with adolescent patients in acute care settings.
This article reviews 7 randomized controlled trials evaluating risky drinking interventions among adolescent patients in acute care settings. All studies took place in the emergency departments of level I trauma centers.
Four of the 7 studies reviewed demonstrated a significant intervention effect; however, no one intervention reduced both alcohol consumption and alcohol-related consequences. Two of these 4 studies only included patients ages 18 and older. Subgroup analyses with adolescents engaged in risky alcohol-related behaviors, conducted in 2 of the studies, showed significant intervention effects. Five studies showed positive consumption and/or consequences for all study participants regardless of condition, suggesting that an emergent injury and/or the screening process may have a protective effect.
Based on existing evidence, it is not clear whether SBIRT is an effective approach to risky alcohol use among adolescent patients in acute care. Additional research is needed around interventions and implementation.
青少年饮酒现象普遍存在，与许多负面的健康和社会后果有关。接受紧急治疗的青少年因受伤而经常与危险的饮酒行为有关。创伤系统广泛采用了筛查、简短干预和转介治疗（SBIRT），以预防与酒精相关的伤害复发和其他负面后果。本文的目的是综述在急性护理环境中对青少年患者进行 SBIRT 的证据。
本文综述了 7 项在急性护理环境中评估青少年患者危险饮酒干预的随机对照试验。所有研究均在一级创伤中心的急诊部进行。
7 项研究中有 4 项显示出显著的干预效果；然而，没有一种干预措施既能减少饮酒量，又能减少与酒精相关的后果。这 4 项研究中有 2 项仅纳入 18 岁及以上的患者。对其中 2 项研究中的青少年危险饮酒行为进行亚组分析显示出显著的干预效果。5 项研究显示所有研究参与者无论条件如何都有积极的消费和/或后果，这表明急性损伤和/或筛查过程可能具有保护作用。
根据现有证据，尚不清楚 SBIRT 是否是急性护理中青少年患者危险饮酒的有效方法。需要进一步研究干预措施和实施情况。
