OBJECTIVE: Alcoholism is the leading risk factor for injury. The authors hypothesized that providing brief alcohol interventions as a routine component of trauma care would significantly reduce alcohol consumption and would decrease the rate of trauma recidivism. METHODS: This study was a randomized, prospective controlled trial in a level 1 trauma center. Patients were screened using a blood alcohol concentration, gamma glutamyl transpeptidase level, and short Michigan Alcoholism Screening Test (SMAST). Those with positive results were randomized to a brief intervention or control group. Reinjury was detected by a computerized search of emergency department and statewide hospital discharge records, and 6- and 12-month interviews were conducted to assess alcohol use. RESULTS: A total of 2524 patients were screened; 1153 screened positive (46%). Three hundred sixty-six were randomized to the intervention group, and 396 to controls. At 12 months, the intervention group decreased alcohol consumption by 21.8+/-3.7 drinks per week; in the control group, the decrease was 6.7+/-5.8 (p = 0.03). The reduction was most apparent in patients with mild to moderate alcohol problems (SMAST score 3 to 8); they had 21.6+/-4.2 fewer drinks per week, compared to an increase of 2.3+/-8.3 drinks per week in controls (p < 0.01). There was a 47% reduction in injuries requiring either emergency department or trauma center admission (hazard ratio 0.53, 95% confidence interval 0.26 to 1.07, p = 0.07) and a 48% reduction in injuries requiring hospital admission (3 years follow-up). CONCLUSION:Alcohol interventions are associated with a reduction in alcohol intake and a reduced risk of trauma recidivism. Given the prevalence of alcohol problems in trauma centers, screening, intervention, and counseling for alcohol problems should be routine.
RCT Entities:
OBJECTIVE: Alcoholism is the leading risk factor for injury. The authors hypothesized that providing brief alcohol interventions as a routine component of trauma care would significantly reduce alcohol consumption and would decrease the rate of trauma recidivism. METHODS: This study was a randomized, prospective controlled trial in a level 1 trauma center. Patients were screened using a blood alcohol concentration, gamma glutamyl transpeptidase level, and short Michigan Alcoholism Screening Test (SMAST). Those with positive results were randomized to a brief intervention or control group. Reinjury was detected by a computerized search of emergency department and statewide hospital discharge records, and 6- and 12-month interviews were conducted to assess alcohol use. RESULTS: A total of 2524 patients were screened; 1153 screened positive (46%). Three hundred sixty-six were randomized to the intervention group, and 396 to controls. At 12 months, the intervention group decreased alcohol consumption by 21.8+/-3.7 drinks per week; in the control group, the decrease was 6.7+/-5.8 (p = 0.03). The reduction was most apparent in patients with mild to moderate alcohol problems (SMAST score 3 to 8); they had 21.6+/-4.2 fewer drinks per week, compared to an increase of 2.3+/-8.3 drinks per week in controls (p < 0.01). There was a 47% reduction in injuries requiring either emergency department or trauma center admission (hazard ratio 0.53, 95% confidence interval 0.26 to 1.07, p = 0.07) and a 48% reduction in injuries requiring hospital admission (3 years follow-up). CONCLUSION:Alcohol interventions are associated with a reduction in alcohol intake and a reduced risk of trauma recidivism. Given the prevalence of alcohol problems in trauma centers, screening, intervention, and counseling for alcohol problems should be routine.
Authors: Kadian S Sinclair; Tavis S Campbell; Patricia M Carey; Eric Langevin; Brent Bowser; Christopher R France Journal: Transfusion Date: 2010-04-23 Impact factor: 3.157
Authors: Joseph P Minei; Robert H Schmicker; Jeffrey D Kerby; Ian G Stiell; Martin A Schreiber; Eileen Bulger; Samuel Tisherman; David B Hoyt; Graham Nichol Journal: Ann Surg Date: 2010-07 Impact factor: 12.969
Authors: Brendan J Clark; Alexandra Smart; Robert House; Ivor Douglas; Ellen L Burnham; Marc Moss Journal: Alcohol Clin Exp Res Date: 2011-09-26 Impact factor: 3.455
Authors: Gail D'Onofrio; Michael V Pantalon; Linda C Degutis; David A Fiellin; Patrick G O'connor Journal: Acad Emerg Med Date: 2005-03 Impact factor: 3.451
Authors: Joseph E Glass; Ashley M Hamilton; Byron J Powell; Brian E Perron; Randall T Brown; Mark A Ilgen Journal: Addiction Date: 2015-06-03 Impact factor: 6.526
Authors: Francine Terrell; Douglas F Zatzick; Gregory J Jurkovich; Frederick P Rivara; Dennis M Donovan; Christopher W Dunn; Carol Schermer; Jay Wayne Meredith; Larry M Gentilello Journal: J Am Coll Surg Date: 2008-07-14 Impact factor: 6.113