Identification of hazardous/harmful drinking among subcritically injured patients.
OBJECTIVE
To examine the relationship between a saliva alcohol test (SAT) and hazardous/harmful drinking, as measured by the Alcohol Use Disorders Identification Test (AUDIT), among a sample of subcritically injured patients.


METHODS
Patients (n = 78) seeking treatment for a subcritical injury were saliva-tested for alcohol and interviewed regarding their drinking behaviors and related difficulties. Associations of SAT values with AUDIT results were determined.


RESULTS
SAT results and hazardous/harmful drinking were not independent events (p < 0.001). Estimates of sensitivity and specificity (using a dichotomous SAT result [> or = 4 mmol/L] to identify positive AUDIT patients) were 65.2% and 83.6%, respectively. SAT-positive people had significantly higher AUDIT scores than did SAT-negative individuals (p < 0.0001). Patients experiencing assault-type injuries were much more likely to be SAT-positive than were patients incurring other types of injury. Discriminant function analysis suggests that AUDIT scores can successfully identify SAT-positive and SAT-negative patients; the analysis accounted for 42.5% of the variance and correctly classified 84.6% of the sample.


CONCLUSIONS
The use of an easy-to-administer, noninvasive, routine SAT, among patients presenting for a subcritical injury in a hospital ED, provides a mechanism for the identification of individuals with a history of hazardous/harmful drinking. However, since discrimination of hazardous/harmful drinking is imperfect, some caution is warranted when conducting such screening activities.
Clifford
P R
PR
New York University, Department of Health Studies, New York 10012-1172, USA. cliffrd@stats1.nyu.edu
Sparadeo
F
F
Minugh
P A
PA
Nirenberg
T D
TD
Woolard
R
R
Longabaugh
R
R
Becker
B
B
D000057:Accident Proneness; D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D000704:Analysis of Variance; D004636:Emergency Service, Hospital; D000431:Ethanol / Q000032:analysis*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012463:Saliva / Q000737:chemistry*; D012680:Sensitivity and Specificity; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications*
D000431:Ethanol