Buchfuhrer L A, Radecki S E
Long Beach Memorial Medical Center Family Practice Residency, University of California Irvine 92668-3298, USA.
J Addict Dis. 1996;15(1):65-74. doi: 10.1300/J069v15n01_05.
Studies of the prevalence of alcohol and drug abuse among trauma patients have produced recommendations that all trauma patients be screened for these substances. But a national survey of trauma centers showed that just 72.0% of level 1 trauma centers routinely obtain blood alcohol levels on trauma patients and only 50.4% routinely utilize toxicology screens. Utilizing patient summary data collected on 2,246 trauma patients treated in the Emergency Department of Long Beach (CA) Memorial Medical Center over a 2.5 year period, and laboratory results for a random sample of 246 of these patients, this study sought to determine patient and presenting problem characteristics associated with screening and positive test results in centers (such as ours) where screening is done selectively. Results show that 75.4% of trauma patients are screened for blood alcohol levels, and 58.5% are given a urine toxicology, with lowest rates for 12-20 year olds and highest rates for patients over 40 who were confused or incomprehensible. Men were slightly more likely to be screened for blood alcohol than women, but their positivity rate was 2.5 times higher; by contrast, the toxicology positivity rate did not differ significantly by gender. A positive finding for either test was associated with a 40% higher rate of positivity for the other.
关于创伤患者酒精和药物滥用患病率的研究提出了建议，即应对所有创伤患者进行这些物质的筛查。但一项针对创伤中心的全国性调查显示，只有72.0%的一级创伤中心会定期检测创伤患者的血液酒精含量，只有50.4%的中心会定期进行毒理学筛查。本研究利用在加利福尼亚州长滩纪念医疗中心急诊科2.5年期间收治的2246名创伤患者的患者总结数据，以及其中246名患者的随机样本的实验室结果，试图确定在像我们这样进行选择性筛查的中心，与筛查及阳性检测结果相关的患者和就诊问题特征。结果显示，75.4%的创伤患者接受了血液酒精含量检测，58.5%的患者接受了尿液毒理学检测，12至20岁患者的检测率最低，40岁以上意识模糊或无法理解的患者检测率最高。男性接受血液酒精检测的可能性略高于女性，但其阳性率高出2.5倍；相比之下，毒理学检测的阳性率在性别上没有显著差异。任一检测的阳性结果与另一检测40%的更高阳性率相关。
