Alcoholism assessment on an orthopaedic surgery service

We reviewed the initial history, obtained by the orthopaedic house staff, of each of eighty-seven patients who were consecutively admitted to an acute orthopaedic-surgery service. A diagnosis of alcoholism was made by the house staff in only one of every ten patients who had been identified as having symptoms of alcohol addiction in a previous study. Alcohol abuse was identified in only five of every ten such patients. Of the orthopaedic patients in this sample who had been shown to be abusing alcohol, 37 per cent were neither suspected nor diagnosed as abusers by the orthopaedic house staff. We recommend the use of a brief screening interview (CAGE) to increase diagnostic effectiveness in this area, and discuss the clinical usefulness of an early diagnosis of alcoholism among orthopaedic surgical patients.