A comparison of alcohol-positive and alcohol-negative trauma patients.
OBJECTIVE
Hospital admission for an alcohol-related traumatic injury may offer a "teachable moment" to address a patient's alcohol problem. Although trauma teams provide a number of other health-related services, there may be characteristics of alcohol-positive victims that act as barriers toward providing alcohol counseling. The purpose of this study was to compare the characteristics and hospital outcomes of trauma patients who tested positive for alcohol at the time of hospital admission with those who did not. This information is useful for planning interventions and referrals for treatment.


METHODS
The study was a retrospective comparison of alcohol-positive and alcohol-negative patients who were admitted for at least 48 hours to a Level-I trauma center. Data from 1,049 trauma victims (736 male, 742 alcohol-negative) were abstracted from clinical records.


RESULTS
Several characteristics were found to be associated with alcohol-related injuries: being male, aged 40 years or less, having a toxicology screen positive for illicit drugs, lacking health insurance, being indigent and sustaining an injury related to violence. Alcohol-positive patients were also found to spend fewer days in a critical care unit, to be less likely to die and to be less likely to be transferred to another hospital than alcohol-negative patients, despite having similar injury severity.


CONCLUSIONS
Patient characteristics suggest that there are obstacles to providing interventions and referrals by healthcare professionals for victims of alcohol-related injuries. Less expensive options that consider the demographic features of this patient population need to be developed as an alternative to expensive, professional interventions.
Blondell
Richard D
RD
Department of Family and Community Medicine, University of Louisville School of Medicine, Kentucky 40202, USA. Richard.Blondell@louisville.edu
Looney
Stephen W
SW
Krieg
Christopher L
CL
Spain
David A
DA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data; D000431:Ethanol / Q000097:blood; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology; D014193:Trauma Centers / Q000706:statistics & numerical data; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology*
D013287:Illicit Drugs; D000431:Ethanol