Adolescent injury in the emergency department: opportunity for alcohol interventions?
OBJECTIVE
Alcohol, the most commonly used substance among adolescents, is frequently associated with injury. Little is known regarding the drinking characteristics of injured adolescents. Such data are critical for developing emergency department interventions to decrease alcohol-related injury among adolescents. We sought to describe the drinking characteristics of injured adolescents and to describe the relationship of injury severity and mechanisms with drinking characteristics.


METHODS
This study was a prospective cohort study performed in a university hospital (sampled May 1, 1995, to July 15, 1995) and a large urban teaching hospital (sampled May 1, 1996, to August 1, 1996). The participants were aged 12 to 20 years, presenting within 6 hours of an injury. We performed a saliva alcohol test and self-administered questionnaire. Age, sex, E-code, injury severity score (ISS), and ED disposition were recorded. An alcohol frequency/quantity index was calculated. Descriptive statistics and 95% confidence intervals were calculated.


RESULTS
Two hundred sixty-three patients with a mean age of 17 years and a mean ISS of 2.1 (SD 3.5) were recruited. One hundred fifty-two (50%) were males, and 33 (13%) were admitted. Ten (4%) patients had a positive saliva alcohol test response. On average, within the last year, these adolescents had 1.7 adverse alcohol consequences. Sixty percent drank in unsupervised settings, and 36% reported drinking 5 or more drinks in a row.


CONCLUSIONS
Alcohol use/misuse is a substantial problem among injured adolescents regardless of severity or mechanism of injury. ED physicians should consider screening/intervention or primary prevention of alcohol problems for all injured adolescents.
Maio
R F
RF
University of Michigan Injury Research Center, Department of Emergency Medicine, Ann Arbor, MI, USA. ronmaio@umich.edu
Shope
J T
JT
Blow
F C
FC
Copeland
L A
LA
Gregor
M A
MA
Brockmann
L M
LM
Weber
J E
JE
Metrou
M E
ME
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D000431:Ethanol / Q000032:analysis; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry; D011795:Surveys and Questionnaires; D014505:Urban Population; D014947:Wounds and Injuries / Q000209:etiology / Q000523:psychology*
D000431:Ethanol