title: Association between alcohol screening results and hospitalizations for trauma in Veterans Affairs outpatients.
abstract: BACKGROUND
  Alcohol consumption is a risk factor for traumatic injury, but it is unknown whether responses to alcohol screening questionnaires administered routinely in primary care are associated with subsequent hospitalization for traumatic injury.
  
  
  OBJECTIVE
  We evaluated the association between alcohol screening scores and the risk for subsequent hospitalizations for trauma among Veterans Affairs (VA) general medicine patients.
  
  
  METHODS
  This study included VA outpatients (n = 32,623) at seven sites who returned mailed surveys (1997-1999). Alcohol Use Disorders Identification Test Consumption (AUDIT-C) scores grouped patients into six drinking categories representing nondrinkers, screen-negative drinkers, and drinkers who screened positive for mild, moderate, severe, and very severe alcohol misuse (scores 0, 1-3, 4-5, 6-7, 8-9, 10-12, respectively). VA administrative and Medicare data identified primary discharge diagnoses for trauma. Cox proportional hazard models were used to estimate the risk of trauma-related hospitalization for each drinking group adjusted for demographics, smoking, and comorbidity.
  
  
  RESULTS
  Compared with screen-negative drinkers, patients with severe and very severe alcohol misuse (AUDIT-C 8-9 and ≥10) were at significantly increased risk for trauma-related hospitalization over the follow-up period (adjusted hazard ratios AUDIT-C: 8-9 2.06, 95% confidence interval (CI) 1.31- 3.24 and AUDIT-C≥10 2.13, 95% CI 1.32-3.42).
  
  
  CONCLUSIONS
  Patients with severe and very severe alcohol misuse had a twofold increased risk of hospital admission for trauma compared to drinkers without alcohol misuse.
  
  
  CONCLUSIONS
  Alcohol screening scores could be used to provide feedback to patients regarding risk of trauma-related hospitalization. Findings could be used by providers during brief alcohol-related interventions with patients with alcohol misuse.
authors.affiliation: Health Services Research & Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98101, USA. emily.williams3@va.gov
authors.forename: Emily C
authors.initials: EC
authors.lastname: Williams
authors.forename: Chris L
authors.initials: CL
authors.lastname: Bryson
authors.forename: Haili
authors.initials: H
authors.lastname: Sun
authors.forename: Ryan B
authors.initials: RB
authors.lastname: Chew
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Chew
authors.forename: David K
authors.initials: DK
authors.lastname: Blough
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Bradley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D012306:Risk; D011795:Surveys and Questionnaires; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health; D014947:Wounds and Injuries / Q000453:epidemiology*