title: Outcomes and resource utilization associated with underage drinking at a level I trauma center.
abstract: OBJECTIVE
  To examine the association of blood alcohol content (BAC) on hospital-based outcomes and imaging utilization for patients <21 years admitted to a level I trauma center.
  
  
  METHODS
  Retrospective analysis of alcohol-involved injuries in patients 13-20 years, admitted to a level I trauma center from 1996 to 2010. An injury was considered alcohol involved if the patient had a BAC > 0. Multivariable logistic regression was used to compare mortality, discharge destination (home and skilled nursing facility), intensive care unit admission, and operating room use between patients with and without positive BAC for patients 13-15, 16-17, and 18-20 years. Multivariable linear regression was used to compare length of hospitalization. Finally, multivariable negative binomial regression evaluated radiology resource utilization (x-ray, computed tomography [CT], and magnetic resonance imaging).
  
  
  RESULTS
  A total of 7,663 patients, 13-20 years old, were admitted over the study period. A positive BAC was reported in 19% of these patients. In general, the presence of alcohol was not associated with mortality rate, length of hospitalization, intensive care unit, and operating room use or discharge status for any age group. However, the presence of alcohol was associated with higher utilization of head (incidence rate ratio [IRR] 1.13, 95% confidence interval [CI] 1.02-1.26), cervical spine (IRR 1.10, 95% CI 1.01-1.22), and thoracic (IRR 1.30, 95% CI 1.05-1.63) CTs in young adults 18-20 years. No differences in CT use were observed in patients 13-15 or 16-17 years.
  
  
  CONCLUSIONS
  Positive BAC was not significantly associated with adverse outcomes or resource utilization in younger trauma patients. However, the use of certain body region CTs was associated with positive BAC in patients 18-20 years.
authors.affiliation: Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: kpsoter1@jhu.edu.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Psoter
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington; Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, Washington.
authors.forename: Bahman S
authors.initials: BS
authors.lastname: Roudsari
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mack
authors.affiliation: Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; Department of Pediatrics, University of Washington, Seattle, Washington.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
authors.affiliation: Department of Radiology, University of Washington, Seattle, Washington; Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, Washington; Department of Neurological Surgery, University of Washington, Seattle, Washington.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D003952:Diagnostic Imaging / Q000191:economics*; D000431:Ethanol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000431:Ethanol
keywords: Adolescent; Computed tomography; Injuries; Outcomes; Pediatric; Resource utilization; Trauma; Underage drinking