Lisa M Kodadek1, Jennifer J Freeman, Devesh Tiwary, Mack Dillon Drake, M Elizabeth Schroeder, Linda Dultz, Cassandra White, Hiba Abdel Aziz, Marie Crandall, John J Como, Rishi Rattan. 1. From the Division of Trauma and Surgical Critical Care (L.M.K.), Vanderbilt University Medical Center, Nashville, Tennessee; General Surgery, Trauma, and Surgical Critical Care (J.J.F.), Texas Health Harris Hospital, Fort Worth, Texas; Central Florida Regional Hospital (D.T.), Sanford, Florida; Trauma and Surgical Critical Care (M.D.D.), Brody School of Medicine at East Carolina University, Greenville, North Carolina; Department of Surgery (M.E.S.), Rutgers-Robert Wood Johnson University Hospital, New Brunswick, New Jersey; Division of General and Acute Care Surgery (L.D.), University of Texas Southwestern Parkland Hospital, Dallas, Texas; Department of Surgery, Trauma and Critical Care (C.W.), Medical College of Georgia at Augusta University, Augusta, Georgia; Department of Surgery (H.A.A.), Hamad General Hospital, Doha, Qatar; College of Medicine (M.C.), University of Florida, Jacksonville, Florida; Department of Surgery (J.J.C.), MetroHealth Medical Center, Cleveland, Ohio; and Department of Surgery (R.R.), University of Miami Miller School of Medicine, Miami, Florida.
Abstract
BACKGROUND: Unaddressed alcohol use among injured patients may result in recurrent injury or death. Many trauma centers incorporate alcohol screening, brief intervention, and referral to treatment for injured patients with alcohol use disorders, but systematic reviews evaluating the impact of these interventions are lacking. METHODS: An evidence-based systematic review was performed to answer the following population, intervention, comparator, outcomes question: Among adult patients presenting for acute injury, should emergency department, trauma center, or hospital-based alcohol screening with brief intervention and/or referral to treatment be instituted compared with usual care to prevent or decrease reinjury, hospital readmission, alcohol-related offenses, and/or alcohol consumption? A librarian-initiated query of PubMed, MEDLINE, and the Cochrane Library was performed. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of the evidence and create recommendations. The study was registered with PROSPERO (registration number CRD42019122333). RESULTS: Eleven studies met criteria for inclusion, with a total of 1,897 patients who underwent hospital-based alcohol screening, brief intervention, and/or referral to treatment for appropriate patients. There was a relative paucity of data, and studies varied considerably in terms of design, interventions, and outcomes of interest. Overall evidence was assessed as low quality, but a large effect size of intervention was present. CONCLUSION: In adult trauma patients, we conditionally recommend emergency department, trauma center, or hospital-based alcohol screening with brief intervention and referral to treatment for appropriate patients in order to reduce alcohol-related reinjury. LEVEL OF EVIDENCE: Systematic review, Level III.
BACKGROUND: Unaddressed alcohol use among injured patients may result in recurrent injury or death. Many trauma centers incorporate alcohol screening, brief intervention, and referral to treatment for injured patients with alcohol use disorders, but systematic reviews evaluating the impact of these interventions are lacking. METHODS: An evidence-based systematic review was performed to answer the following population, intervention, comparator, outcomes question: Among adult patients presenting for acute injury, should emergency department, trauma center, or hospital-based alcohol screening with brief intervention and/or referral to treatment be instituted compared with usual care to prevent or decrease reinjury, hospital readmission, alcohol-related offenses, and/or alcohol consumption? A librarian-initiated query of PubMed, MEDLINE, and the Cochrane Library was performed. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of the evidence and create recommendations. The study was registered with PROSPERO (registration number CRD42019122333). RESULTS: Eleven studies met criteria for inclusion, with a total of 1,897 patients who underwent hospital-based alcohol screening, brief intervention, and/or referral to treatment for appropriate patients. There was a relative paucity of data, and studies varied considerably in terms of design, interventions, and outcomes of interest. Overall evidence was assessed as low quality, but a large effect size of intervention was present. CONCLUSION: In adult traumapatients, we conditionally recommend emergency department, trauma center, or hospital-based alcohol screening with brief intervention and referral to treatment for appropriate patients in order to reduce alcohol-related reinjury. LEVEL OF EVIDENCE: Systematic review, Level III.
Authors: Deepika Nehra; Eileen M Bulger; Ronald V Maier; Kathleen E Moloney; Joan Russo; Jin Wang; Kristina Anderson; Douglas F Zatzick Journal: Ann Surg Date: 2021-10-01 Impact factor: 13.787
Authors: Douglas Zatzick; Kathleen Moloney; Lawrence Palinkas; Peter Thomas; Kristina Anderson; Lauren Whiteside; Deepika Nehra; Eileen Bulger Journal: Med Care Date: 2021-08-01 Impact factor: 2.983