Johnson Kevin N, Raetz Alaina, Harte Melissa, McMahon Lisa E, Grandsoult Victoria, Garcia-Filion Pamela, Notrica David M
Department of General Surgery, Mayo Clinic, Phoenix, Arizona.
Trauma Center, Phoenix Children's Hospital, Phoenix, Arizona.
J Pediatr Surg. 2014 Feb;49(2):330-2. doi: 10.1016/j.jpedsurg.2013.10.012. Epub 2013 Oct 19.
Alcohol use is a risk factor for adult trauma. Alcohol may significantly influence pediatric trauma risk, but literature is sparse. The aim of this study was to examine the impact of alcohol use screening in pediatric trauma patients.
A retrospective review was performed of all trauma patients to identify those undergoing CRAFFT alcohol screening assessment between July 1, 2009, and January 31, 2011. Inclusion criteria involved screening of level 1 or 2 trauma activations for patients greater than 12 years.
During the study period, 232 patients were eligible for screening, of which 51% (n=118) were screened. Among the patients screened, 21 (18%) had a positive screen (mean age 14.6 years, range 13-16). Twenty patients were referred for further counseling. Sixteen males and 5 females screened positive during the study. The most common mechanism of injury in the positive screen patients was motor vehicle or ATV accident (n=9), followed by assault (n=6), and motor versus pedestrian collision (n=2). Of the 21 patients who screened positive, 10 had positive blood alcohol content (BAC) or urine drug screen (UDS) at the time of injury. No patients with a positive screen returned during the study as a trauma patient.
Alcohol and drug screening for injured pediatric trauma patients is frequently omitted despite policy-required screening. Of those patients screened, 18% admitted to risky alcohol or drug-related behaviors or had positive BAL or UDS at presentation. Pediatric trauma screening for risky alcohol use identifies a significant number of children. Alcohol and drug screening in pediatric trauma appears over age 13 years to have a yield which justifies continued screening. Alcohol related trauma recidivism, however, does not seem common.
饮酒是成人创伤的一个风险因素。酒精可能会显著影响儿童创伤风险，但相关文献较少。本研究的目的是探讨酒精使用筛查对儿童创伤患者的影响。
对所有创伤患者进行回顾性研究，以确定在2009年7月1日至2011年1月31日期间接受CRAFFT酒精筛查评估的患者。纳入标准包括对12岁以上患者进行1级或2级创伤激活筛查。
在研究期间，232例患者符合筛查条件，其中51%（n = 118）接受了筛查。在接受筛查的患者中，21例（18%）筛查呈阳性（平均年龄14.6岁，范围13 - 16岁）。20例患者被转介接受进一步咨询。在研究期间，16名男性和5名女性筛查呈阳性。筛查呈阳性的患者中最常见的受伤机制是机动车或全地形车事故（n = 9），其次是袭击（n = 6）和机动车与行人碰撞（n = 2）。在21例筛查呈阳性的患者中，10例在受伤时血液酒精含量（BAC）或尿液药物筛查（UDS）呈阳性。在研究期间，没有筛查呈阳性的患者作为创伤患者再次就诊。
尽管有政策要求进行筛查，但受伤儿童创伤患者的酒精和药物筛查经常被遗漏。在接受筛查的患者中，18%承认有危险的酒精或药物相关行为，或在就诊时BAL或UDS呈阳性。对儿童创伤患者进行危险饮酒筛查可识别出大量儿童。13岁以上儿童创伤患者的酒精和药物筛查似乎具有一定的阳性检出率，值得继续进行筛查。然而，与酒精相关的创伤再发似乎并不常见。
