OBJECTIVE: To determine the effect of admission for trauma with concurrent acute alcohol intoxication or chronic alcohol abuse on the risk of subsequent recurrence of trauma. DESIGN: Prospective cohort study. SETTING: Level I regional trauma center. PATIENTS: A total of 2578 patients 18 years or older admitted with blunt or penetrating trauma within 24 hours of injury and surviving to discharge. All patients had a blood alcohol concentration (BAC) test, a gamma-glutamyltransferase (GGT) test, and the short Michigan Alcohol Screening Test (SMAST) performed on admission. MAIN OUTCOME MEASUREMENT: Readmission to the trauma center for new trauma. Average follow-up was 28 months (range, 16 to 40 months). RESULTS: The overall rate of readmission for new injuries was 1.3 per 1000 patient-months of follow-up. Patients who were intoxicated on the initial admission (BAC > 22 mmol/L [100 mg/dL]) were 2.5-fold as likely to be readmitted than those not intoxicated (95% confidence limits, 1.6, 3.9). The relative risks for patients with positive SMAST scores and abnormal GGT values were 2.2 (95% confidence limits, 1.4, 3.5) and 3.5 (95% confidence limits, 2.2, 5.5), respectively. The increased risks remained significant for intoxication and abnormal GGT values after adjustment for gender, race, Medicaid status, and mechanism of injury. CONCLUSION: Alcohol abuse is associated with an increased risk of readmission for new trauma. Trauma patients should be screened for alcohol problems; referral of problem drinkers for appropriate care may decrease their risk of admission for subsequent trauma.
OBJECTIVE: To determine the effect of admission for trauma with concurrent acute alcohol intoxication or chronic alcohol abuse on the risk of subsequent recurrence of trauma. DESIGN: Prospective cohort study. SETTING: Level I regional trauma center. PATIENTS: A total of 2578 patients 18 years or older admitted with blunt or penetrating trauma within 24 hours of injury and surviving to discharge. All patients had a blood alcohol concentration (BAC) test, a gamma-glutamyltransferase (GGT) test, and the short Michigan Alcohol Screening Test (SMAST) performed on admission. MAIN OUTCOME MEASUREMENT: Readmission to the trauma center for new trauma. Average follow-up was 28 months (range, 16 to 40 months). RESULTS: The overall rate of readmission for new injuries was 1.3 per 1000 patient-months of follow-up. Patients who were intoxicated on the initial admission (BAC > 22 mmol/L [100 mg/dL]) were 2.5-fold as likely to be readmitted than those not intoxicated (95% confidence limits, 1.6, 3.9). The relative risks for patients with positive SMAST scores and abnormal GGT values were 2.2 (95% confidence limits, 1.4, 3.5) and 3.5 (95% confidence limits, 2.2, 5.5), respectively. The increased risks remained significant for intoxication and abnormal GGT values after adjustment for gender, race, Medicaid status, and mechanism of injury. CONCLUSION:Alcohol abuse is associated with an increased risk of readmission for new trauma. Traumapatients should be screened for alcohol problems; referral of problem drinkers for appropriate care may decrease their risk of admission for subsequent trauma.
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
Authors: Ville M Mattila; Mirjami Pelkonen; Markus Henriksson; Mauri Marttunen Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2008-04-03 Impact factor: 4.328