University of Utah School of Medicine, 30 N 1900 E, Salt Lake City, UT, 84132, United States.
University of Utah Health Burn Center, 50 N Medical Dr., Salt Lake City, UT, 84132, United States.
Burns. 2019 Aug;45(5):1182-1188. doi: 10.1016/j.burns.2019.03.004. Epub 2019 Apr 1.
Substance use is disproportionately high in burn patients and associated with adverse outcomes. Screening methods for substance use disorders may help predict or avoid adverse outcomes. The University of Utah Burn Center records self-reported Alcohol Use Disorders Identification Tests (AUDIT) and Drug Abuse Screening Tests (DAST-10) for all adult burn admissions. This study assessed for association between AUDIT/DAST-10 scores and burn patient outcomes.
A retrospective chart review of adult burn patients admitted to the University of Utah from 05/01/2014-06/30/2017. Patient demographics, injury data, and substance use data were collected and analyzed.
322 patients underwent AUDIT/DAST-10 screening (n = 322). 56 (17.4%) had positive AUDIT screens (score ≥ 8). 15/50 with alcohol use at time of injury (TOI) had negative AUDIT screens. Median AUDIT score with TOI alcohol use was 12, without TOI alcohol use was 1. 30/55 patients offered alcohol counseling accepted. 14 patients (4.3%) had positive DAST-10 screens (score ≥3). 9/25 with drug use at TOI had negative DAST-10 screens. No patients without TOI drug use had DAST-10 scores >2. 9/11 patients offered drug counseling accepted. Mean standardized length of stay (LOS) per TBSA burn injury was 1.7 days for positive AUDIT, 1.6 days for negative AUDIT. Median standardized LOS was 1.4 days for positive DAST-10, 1.7 days for negative DAST-10.
AUDIT and DAST-10 screens can identify burn patients with problematic substance use, allowing early intervention. Positive screening scores do not independently predict longer hospital stays, increased wound severity, or treatment noncompliance.
物质使用在烧伤患者中比例过高，并与不良结局相关。物质使用障碍的筛查方法可能有助于预测或避免不良结局。犹他大学烧伤中心为所有成年烧伤患者入院记录自我报告的酒精使用障碍识别测试（AUDIT）和药物滥用筛查测试（DAST-10）。本研究评估了 AUDIT/DAST-10 评分与烧伤患者结局之间的关系。
对 2014 年 5 月 1 日至 2017 年 6 月 30 日期间在犹他大学接受治疗的成年烧伤患者进行回顾性图表审查。收集并分析了患者的人口统计学、损伤数据和物质使用数据。
322 名患者接受了 AUDIT/DAST-10 筛查（n=322）。56 名（17.4%）有阳性 AUDIT 筛查结果（得分≥8）。15 名在受伤时（TOI）有饮酒行为的患者中有 50 名阴性 AUDIT 筛查结果。有 TOI 酒精使用的 AUDIT 评分中位数为 12，无 TOI 酒精使用的 AUDIT 评分中位数为 1。30 名接受酒精咨询的患者中有 55 名接受了咨询。14 名（4.3%）患者有阳性 DAST-10 筛查结果（得分≥3）。9 名在 TOI 有药物使用的患者中有 25 名阴性 DAST-10 筛查结果。无 TOI 药物使用的患者的 DAST-10 评分均未超过 2。9 名接受药物咨询的患者中有 11 名接受了咨询。阳性 AUDIT 的每 1%TBSA 烧伤损伤标准化平均住院时间（LOS）为 1.7 天，阴性 AUDIT 的 LOS 为 1.6 天。阳性 DAST-10 的标准化 LOS 中位数为 1.4 天，阴性 DAST-10 的 LOS 中位数为 1.7 天。
AUDIT 和 DAST-10 筛查可以识别有问题物质使用的烧伤患者，从而进行早期干预。阳性筛查评分并不能独立预测住院时间延长、伤口严重程度增加或治疗不依从。
