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The magnitude of acute and chronic alcohol abuse in trauma patients
F P Rivara1, G J Jurkovich, J G Gurney
1Harborview Injury Prevention and Research Center, Harborview Medical Center, Seattle, Wash.
Objective:
To assess the incidence of acute alcohol intoxication and the proportion of trauma patients with evidence of chronic alcohol abuse.
Design:
Prospective cohort study.
Setting:
Regional level I trauma center.
Participants:
Patients aged 18 years and older admitted with blunt or penetrating trauma.
Main Outcome Measures:
Admission blood alcohol concentrations (BACs), the Short Michigan Alcohol Screening Test (SMAST), and biochemical markers for chronic alcohol abuse.
Results:
Of the 2657 patients enrolled, 47.0% had a positive BAC and 35.8% were intoxicated (BAC > or = 100 mg/dL) on admission to the emergency department. Intoxicated patients were more likely to be 25 to 34 years old, male, and nonwhite; the highest proportion of intoxicated patients was among victims of stab wounds. Three fourths of acutely intoxicated patients had evidence of chronic alcoholism as indicated by a positive SMAST, and 25% to 35% of acutely intoxicated patients had biochemical evidence of chronic alcohol abuse.
Conclusions:
The high prevalence of both acute intoxication and chronic alcoholism in trauma patients indicates the need to diagnose and appropriately treat this pervasive problem in trauma victims.