Alcohol interventions for trauma patients are not just for adults: justification for brief interventions for the injured adolescent at a pediatric trauma center.
BACKGROUND
Research on the rates of alcohol and drug misuse as well as developmentally appropriate screening and intervention approaches in a hospitalized pediatric trauma population are lacking. The purpose of this study was to identify the rate of alcohol misuse in an admitted trauma population of adolescents aged 11 years to 17 years and to identify key correlates of alcohol misuse in this population including age, gender, and injury severity.


METHODS
A prospective clinical study of 230 injured youth (aged 11-17 years) comprising both hospitalized and emergency department (ED) population was performed, and the patients were screened for the Alcohol Use Disorders Identification Test (AUDIT), blood alcohol levels (BALs), and drinking and driving index. The main outcome measures were rates of alcohol misuse characterized by a positive BAL or a positive AUDIT.


RESULTS
Thirty percent hospitalized trauma patients screened positive for alcohol misuse. Five patients had a positive BAL without a positive AUDIT score. Binge drinking was the most commonly positive domain of the AUDIT tool. In hospitalized trauma patients who are older than 14 years (p = 0.005), it was significantly associated with a positive AUDIT score, but the injury severity score, gender, mechanism of injury, or positive BAL were not significant predictors. In the ED sample, 15.8% of patients had a positive AUDIT score. One-way analysis of variance among the ED group showed that age >or=14 was the single predictor of a positive AUDIT score. Twenty-three percent of hospitalized patients had been in a car, where the driver had been drinking. The average AUDIT scores in this group was 5.3 versus 1.0 (p < 0.001), compared with those who had not ridden in a car with a driver who had been drinking.


CONCLUSIONS
Injured youth admitted to a pediatric trauma center are a high-risk population. Alcohol misuse is a significant cofactor for trauma for these patients, and effective developmentally appropriate interventions are justified and needed.
Ehrlich
Peter F
PF
Department of Surgery, Section of Pediatric Surgery, CS Mott Children's Hospital, University of Michigan School of Medicine, Ann Arbor, Michigan 48103, USA. pehrlich@med.umich.edu
Maio
Ron
R
Drongowski
Robert
R
Wagaman
Mathew
M
Cunningham
Rebecca
R
Walton
Maureen A
MA
D000063:Accidents, Traffic; D000293:Adolescent; D000367:Age Factors; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D002648:Child; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008824:Michigan / Q000453:epidemiology; D011446:Prospective Studies; D012737:Sex Factors; D014193:Trauma Centers / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000209:etiology*