Division of Trauma and Critical Care, University of California, Irvine, CA, USA.
J Am Coll Surg. 2012 Oct;215(4):489-95. doi: 10.1016/j.jamcollsurg.2012.05.010. Epub 2012 Jun 9.
Alcohol screening and brief intervention (SBI) is used to decrease alcohol consumption, health care costs, and injury recidivism in trauma patients. Despite SBI being mandated for trauma centers, various concerns have led many centers to conduct SBI only on patients with a detectable blood alcohol concentration (BAC). We sought to determine the predictive nature of BAC on hazardous drinking behavior.
Adult trauma patients were included if they received an SBI before discharge. SBI was administered using a computerized alcohol screening and intervention (CASI) system with the Alcohol Use Disorder Identification Test (AUDIT). Data regarding demographics, injuries, and BAC were prospectively collected. Multivariate analyses were performed to identify independent predictors of hazardous drinking behavior.
Data were complete for 1,340 patients, with a mean age of 43 years (SD 20 years). Sixty-eight percent were male, 33% had detectable BAC, and 19% had hazardous drinking behavior. Multivariate analysis identified age (odds ratio [OR] 0.97 per year), male sex (OR 3.1), BAC (OR 1.009 per mg/dL), detectable BAC (OR 3.9), and legal intoxication (OR 7.8) as independent predictors of hazardous drinking behavior. Asian/Pacific Islander ethnicity was a significant negative predictor (OR 0.53) compared with white. Thirty-eight percent of patients with hazardous drinking behavior had no detectable BAC.
Younger age, male sex, and higher BAC are early predictors of hazardous drinking behavior in adult trauma patients. Asian/Pacific Islander patients are half as likely to report hazardous drinking behavior compared with white patients. More than one-third of patients with hazardous drinking behavior do not have detectable BAC on admission and are not receiving interventions in centers that screen solely based on BAC.
酒精筛查和简短干预（SBI）用于减少创伤患者的酒精消耗、医疗保健费用和伤害复发。尽管 SBI 被强制要求用于创伤中心，但各种担忧导致许多中心仅对血液酒精浓度（BAC）可检测到的患者进行 SBI。我们试图确定 BAC 对危险饮酒行为的预测性质。
如果成年创伤患者在出院前接受 SBI，则将其纳入研究。SBI 使用计算机化酒精筛查和干预（CASI）系统以及酒精使用障碍识别测试（AUDIT）进行管理。前瞻性收集有关人口统计学、损伤和 BAC 的数据。进行多变量分析以确定危险饮酒行为的独立预测因素。
共有 1340 名患者的数据完整，平均年龄为 43 岁（20 岁标准差）。68%为男性，33%有可检测到的 BAC，19%有危险饮酒行为。多变量分析确定年龄（每年 OR 0.97）、男性（OR 3.1）、BAC（每毫克/分升 OR 1.009）、可检测到的 BAC（OR 3.9）和法律醉酒（OR 7.8）是危险饮酒行为的独立预测因素。与白人相比，亚裔/太平洋岛民种族是显著的负预测因素（OR 0.53）。有危险饮酒行为的患者中有 38%没有可检测到的 BAC。
在成年创伤患者中，年龄较小、男性和较高的 BAC 是危险饮酒行为的早期预测因素。与白人患者相比，亚裔/太平洋岛民患者报告危险饮酒行为的可能性低一半。有危险饮酒行为的患者中有超过三分之一在入院时没有可检测到的 BAC，并且在仅根据 BAC 进行筛查的中心没有接受干预。
