Drinking patterns and problems and drinking in the event: an analysis of injury by cause among casualty patients

The association of alcohol and injury might be expected to vary by the specific cause of injury, but few studies have examined such associations across all causes of injury coming from the same population, largely because of the lack of a sufficient number of cases. This study examines the association of drinking patterns and problems and drinking-in-the-injury-event for six mutually exclusive causes of injury (falls, penetrating trauma, motor vehicle accidents, fires, violence, and other causes) in a merged sample of 3109 patients from four emergency room/trauma center studies that used identical study methodology. The predictive value of drinking and demographic variables are examined separately for each cause of injury, and variables predictive of reporting drinking before the event, feeling drunk at the time of injury, and attributing a causal association of drinking and the injury. Injuries sustained from violence and falls had the greatest association with drinking variables, with those with positive breathalyzer readings, and those who reported drinking before injury, frequent heavy drinking, and frequent drunkenness overrepresented in these two causes. Those who reported a larger number of drinks consumed before injury and those who reported feeling drunk at the time were also overrepresented among those with injuries related to violence and falls. A larger proportion than expected of those who attributed a causal association of drinking with the event sustained injuries related to violence, whereas a smaller proportion sustained injuries from falls. Demographic characteristics were more predictive than drinking characteristics of each cause of injury, whereas drinking characteristics, particularly positive breathalyzer readings, were more predictive of drinking before specific causes of injury. These data provide information that may be useful in developing brief interventions for the prevention of alcohol-related injuries in the emergency room or trauma center setting.