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Screening for at-risk drinking behavior in trauma patients.

Timothy P Plackett, Hieu H Ton-That, Jeanne Mueller

    The Journal of the American Osteopathic Association
    |May 30, 2015
    PubMed
    Summary

    The Alcohol Use Disorders Identification Test (AUDIT) score is a better screening tool for at-risk drinking in trauma patients than blood alcohol level. AUDIT offers superior sensitivity and specificity for identifying at-risk drinking behaviors.

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    Area of Science:

    • Trauma Care
    • Addiction Medicine
    • Public Health

    Background:

    • Alcohol use is prevalent in trauma patients, increasing injury risk and worsening outcomes.
    • Screening for at-risk drinking is recommended by the American College of Surgeons Committee on Trauma.
    • Blood alcohol level (BAL) is commonly used, but the Alcohol Use Disorders Identification Test (AUDIT) is a simpler alternative.

    Purpose of the Study:

    • To compare the diagnostic utility of BAL and AUDIT scores in identifying at-risk drinking among trauma patients.
    • To evaluate the performance of BAL and AUDIT against established NIAAA criteria.

    Main Methods:

    • Retrospective cohort study of trauma patients (≥18 years) admitted to a level I trauma center.
    • Inclusion criteria: patients with both BAL and AUDIT scores on admission.
    • At-risk drinking defined as BAL > 0 g/dL or AUDIT score ≥ 8, validated against NIAAA criteria.

    Main Results:

    • 222 of 750 trauma patients (30%) had complete data for both BAL and AUDIT.
    • Positive BAL: 44%; Positive AUDIT: 35%; Meeting NIAAA criteria: 24%.
    • AUDIT sensitivity (83%) and specificity (81%) were superior to BAL (sensitivity 61%, specificity 62%) for identifying at-risk drinking.

    Conclusions:

    • AUDIT score is a more effective stand-alone screening tool for at-risk drinking in trauma patients compared to BAL.
    • Routine use of BAL for screening at-risk drinking in trauma patients warrants reevaluation.