title: A Ten year review of alcohol use and major trauma in a Canadian province: still a major problem.
abstract: BACKGROUND
  Alcohol plays a significant role in major traumatic injuries. While the role of alcohol in motor vehicle trauma (MVT) is well described, its role and approaches to prevention in other injury mechanisms is less defined.
  
  
  METHODS
  A 10 year retrospective examination of Alberta Trauma Registry (ATR) data was conducted on all major trauma patients (age ≥ 9 and ISS ≥ 12) from 2001-2010. The role and prevalence of alcohol is examined.
  
  
  RESULTS
  Of 22,457 patients included in our study, only 60 %(n = 13,552) were screened for alcohol use. Of those screened, 38 %(n = 5,170) tested positive for alcohol with a mean blood alcohol concentration (BAC) of 39.4 ± 21.1 mmol/L. Of the positive screening tests, 82.3 % had BAC levels greater than the common legal driving limit of 17.4 mmol/L (0.08 %). Testing positive was associated with male gender (p < 0.001) and younger age (p < 0.001). The rate of positive alcohol use in major trauma increased from 20.3 % in 2001 to 24.3 % in 2010, corresponding with a screening rate increase from 51.3 % to 61.2 % over the same period. Railway incidents have the highest rate of alcohol involvement (65 %), followed by undetermined-if-accidental/self-inflicted (53.5 %) and assault (49 %); motor vehicle traffic (MVT) incidents had a frequency of 25.4 %.
  
  
  CONCLUSIONS
  The prevalence of alcohol use in major trauma appears to be increasing in Alberta but the true extent is still underappreciated. Furthermore, the role of alcohol in non-MVT injuries is significant and deserves further attention. The vast majority of patients involved in alcohol-related trauma are legally intoxicated. Alcohol use continues to be a substantial contributor to major trauma in Alberta, and represents an important opportunity to reduce preventable injuries.
authors.affiliation: Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, Edmonton, AB Canada.
authors.forename: Jessica
authors.initials: J
authors.lastname: McKee
authors.affiliation: Department of Surgery and Critical Care, University of Alberta, Edmonton, AB Canada.
authors.forename: Sandy L
authors.initials: SL
authors.lastname: Widder
authors.affiliation: Department of Surgery and Critical Care, University of Alberta, Edmonton, AB Canada.
authors.forename: J Damian
authors.initials: JD
authors.lastname: Paton-Gay
authors.affiliation: Department of Surgery and Critical Care Medicine, University of Calgary, Edmonton, AB Canada.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Kirkpatrick
authors.affiliation: Departments of Surgery and Critical Care Medicine, McMaster University, Hamilton, ON Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Engels
keywords: Alcohol; Injury prevention; Trauma