Alcohol and drug use in adult patients with musculoskeletal injuries.

This study reviewed trauma registry data for information on the prevalence of alcohol and drug use in adult patients with fractures and dislocations admitted to Hermann Hospital, Houston, Texas, from January 1992 to December 1994. Of the 1776 adult patients aged 18 years or older, 1126 (63%) were tested for blood alcohol concentration, and 873 (49%) had their urine screened for a panel of 58 drugs. Of the patients tested, 467 (41%) had positive blood alcohol concentrations, and 335 (30%) were legally intoxicated (blood alcohol concentration > or = 0.10%). Of the patients providing urine specimens, 191 (22%) had samples that were positive for one or more drugs. Overall, 9% of the patients tested were positive for both alcohol and drugs, and 54% were positive for either alcohol or drugs. The highest prevalence of alcohol use was in patients aged 21 to 33 years, and men were intoxicated more often than women. Alcohol use was more commonly associated with motor vehicle accidents, pedestrian or bicycle accidents, and gunshot wounds; intoxification was associated with a higher incidence of tibia fractures. The average injury severity score was higher, the duration of stay was longer, and total hospital charges were higher for the alcohol-positive group. Patients testing positive for alcohol or drugs were more likely to lack insurance coverage.