Injury and repeated injury - what is the link with acute consumption, binge drinking and chronic heavy alcohol use?
OBJECTIVE
First, to test whether current injury is more closely related to acute intake than to usual consumption patterns, and second, to test whether repeated injury is more closely related to general consumption patterns than to acute intake.


METHODS
Screening of alcohol consumption of 7,872 patients enrolling between January 1, 2003 and June 30, 2004 in an emergency department (ED) in Lausanne, Switzerland. General consumption patterns were measured as usual volume (in drinks per week) and binge drinking (5+ drinks for men; 4+ drinks for women) at least once monthly. Acute intake was measured through number of drinks in the 24-hour period prior to attending the ED. Separate logistic regression models of current injury and repeated injury on alcohol consumption patterns were estimated.


RESULTS
Acute intake and binge drinking dominated the association with current injury, while general consumption patterns were predictive of repeated alcohol-related injury.


CONCLUSIONS
Acute intake is associated with current injury in a dose-response relationship and with binge drinking. Because acute intake can be found among moderate volume drinkers as well as among chronic heavy drinkers, for current injury usual volume adds little predictive value over the effects of acute intake. Repeated injuries occur more often among chronic heavy drinkers, and thus general consumption patterns are more closely associated with injury "recidivism" than with acute intake. A screening question assessing prior injury may be a useful tool in the ED for distinguishing between chronic heavy drinkers and usually moderate drinkers with heavy drinking episodes, and thus prove helpful when creating preventive efforts tailored to different types of drinker.
Gmel
Gerhard
G
Alchol Treatment Centre, Lausanne University Hospital, Switzerland. gerhard.gmel@chuv.ch
Givel
Jean-Claude
JC
Yersin
Bertrand
B
Daeppen
Jean-Bernard
JB
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000628:therapy; D000437:Alcoholism / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013557:Switzerland / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*