TY - JOUR
T1 - Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence
AU - Gentilello, Larry M.
AU - Rivara, Frederick P.
AU - Donovan, Dennis M.
AU - Jurkovich, Gregory J.
AU - Daranciang, Elizabeth
AU - Dunn, Christopher W.
AU - Villaveces, Andres
AU - Copass, Michael
AU - Ries, Richard R.
PY - 1999/10
Y1 - 1999/10
N2 - 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.
AB - 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.
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U2 - 10.1097/00000658-199910000-00003
DO - 10.1097/00000658-199910000-00003
M3 - Article
C2 - 10522717
AN - SCOPUS:0033503799
SN - 0003-4932
VL - 230
SP - 473
EP - 483
JO - Annals of surgery
JF - Annals of surgery
IS - 4
ER -