计算机化酒精筛查在二级创伤中心比在一级创伤中心识别出更多的高危饮酒者。
Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center.
作者信息
Imani Ghasem, Barrios Cristobal, Anderson Craig L, Hosseini Farahabadi Maryam, Banimahd Faried, Chakravarthy Bharath, Hoonpongsimanont Wirachin, McCoy Christopher E, Mercado Georginne, Farivar Babak, Pham Jacqueline K, Lotfipour Shahram
机构信息
Department of Emergency Medicine, University of California Irvine, Orange, CA, USA.
The Division of Trauma, Burns, Critical Care and Acute Care Surgery, University of California Irvine, Orange, CA, USA.
出版信息
BMC Public Health. 2017 Jan 6;17(1):32. doi: 10.1186/s12889-016-3989-6.
BACKGROUND
Alcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients.
METHODS
This is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center.
RESULTS
A total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8-19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005).
CONCLUSIONS
Findings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted.
背景
酒精滥用被认为是导致受伤的一个重要因素。因此，创伤中心实施筛查和简短干预（SBI）以识别有饮酒问题的患者至关重要。尽管SBI在一级创伤中心识别高危饮酒者方面的效用已得到广泛研究，但在二级中心进行的研究较少。本研究评估SBI在识别高危饮酒者方面的有用性，并调查二级创伤患者的饮酒模式。
方法
这是一项对参与计算机化酒精筛查、简短干预及转介治疗（CASI）的创伤患者便利样本的回顾性研究，这些患者来自一家学术性一级创伤中心和附近的一家郊区社区医院二级创伤中心。CASI利用酒精使用障碍识别测试（AUDIT）对患者进行筛查。我们比较了在二级和一级创伤中心接受筛查的患者的饮酒模式、人口统计学因素及改变意愿得分。
结果
一级和二级创伤中心分别对3850名和1933名入院创伤患者进行了筛查。两个中心在平均年龄、性别和语言方面没有差异。在接受筛查的患者中，一级创伤患者中有10.2%、二级创伤患者中有14.4%的得分属于高危（AUDIT 8 - 19）（p < 0.005）。总体而言，一级创伤患者中有3.7%、二级创伤患者中有7.2%的AUDIT得分与酒精依赖一致（AUDIT >= 20）（p < 0.005）。在对年龄、性别、教育程度和语言进行调整后，二级中心饮酒者的几率是一级中心的两倍（p < 0.005）。二级创伤中心成为高危或依赖饮酒者的几率是一级中心的1.72倍（p < 0.005）。
结论
研究结果表明，SBI在二级创伤中心识别高危饮酒者方面是有效的。与一级创伤中心相比，SBI能够以更高的比率识别所有饮酒者，包括高危和依赖饮酒者。有必要进一步开展研究以评估SBI在改变二级创伤患者饮酒模式方面的有效性。
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