Hazardous drinking by trauma patients during the year after injury.
BACKGROUND
To improve reinjury prevention strategies targeting hazardous drinking, we determined its predictors and longitudinal course in the year after injury.


METHODS
This was a prospective study of 101 randomly selected hospitalized trauma patients who before injury represented the full range of substance abuse, from severe to none. We hypothesized that clinical data obtained routinely by trauma centers would predict hazardous drinking during the postinjury year.


RESULTS
Drug and alcohol use dropped markedly 1 month after injury but returned to preinjury levels by 4 months. Forty-one percent of the sample drank hazardously before injury, and 55% drank hazardously after. From before to after injury, 20% of patients worsened their hazardous drinking status, and only 6% of patients improved it. Three clinical predictors of hazardous drinking during the year were identified: any positive blood alcohol concentration > 0 at admission (odds ratio [OR], 9.18; 95% confidence interval [CI], 2.51-33.56), any days > 0 of using nonprescription drugs of abuse in the month before injury (OR, 6.63; 95% CI, 1.76-25.04), and suffering an intentional injury (OR, 5.1; 95% CI, 1.38-18.77).


CONCLUSIONS
Efforts to reduce hazardous drinking after injury should target patients with this risk profile and focus on the 1- to 4-month period after injury hospitalization.
Dunn
Chris
C
Department of Psychiatry, University of Washington School of Medicine, Seattle, USA. cdunn@u.washington.edu
Zatzick
Douglas
D
Russo
Joan
J
Rivara
Frederick
F
Roy-Byrne
Peter
P
Ries
Rick
R
Wisner
Dave
D
Gentilello
Larry
L
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D016009:Chi-Square Distribution; D000431:Ethanol / Q000097:blood; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D013997:Time Factors; D014193:Trauma Centers / Q000458:organization & administration; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*
D000431:Ethanol