Computerized alcohol screening identified more at-risk drinkers in a level 2 than a level 1 trauma center

Abstract

BackgroundAlcohol abuse is recognized as a significant contributor to injury. It is therefore essential that trauma centers implement screening and brief intervention (SBI) to identify patients who are problem drinkers. Although, the utility of SBI in identifying at-risk drinkers have been widely studied in level 1 trauma centers, few studies have been done in level 2 centers. This study evaluates the usefulness of SBI in identifying at-risk drinkers and to investigate the pattern of alcohol drinking among level 2 trauma patients.MethodsThis is a retrospective study of a convenience sample of trauma patients participating in computerized alcohol screening, brief intervention, and referral to treatment (CASI) in an academic level 1 trauma center and a nearby suburban community hospital level 2 trauma center. CASI utilized Alcohol Use Disorders Identification Test (AUDIT) to screen patients. We compared the pattern of alcohol drinking, demographic factors, and readiness-to-change scores between those screened in a level 2 and 1 trauma center.ResultsA total of 3,850 and 1,933 admitted trauma patients were screened in level 1 and 2 trauma centers respectively. There was no difference in mean age, gender, and language between the two centers. Of those screened, 10.2% of the level 1 and 14.4% of the level 2 trauma patients scored at-risk (AUDIT 8–19) (p < 0.005). Overall, 3.7% of the level 1 and 7.2% of the level 2 trauma patients had an AUDIT score consistent with dependency (AUDIT > =20) (p < 0.005). After adjusting for age, sex, education, and language, the odds of being a drinker at the level 2 center was two times of those at the level 1 center (p < 0.005). The odds of being an at-risk or dependent drinker at level 2 trauma center were 1.72 times of those at the level 1 center (p < 0.005).ConclusionsFindings suggest that SBI is effective in identifying at-risk drinkers in level 2 trauma center. SBI was able to identify all drinkers, including at-risk and dependent drinkers at higher rates in level 2 versus level 1 trauma centers. Further studies to evaluate the effectiveness of SBI in altering drinking patterns among level 2 trauma patients are warranted.

Association of Blood Alcohol and Alcohol Use Disorders with Emergency Department Disposition of Trauma Patients

“…[18][19][20] Despite the self-report bias present in AUDIT, the survey has been shown to be a reliable and well-validated measure to assess habitual alcohol intake in patients. [21][22][23][24][25] Delivering the AUDIT test through a self-administered, computerized system has also been shown to be feasible and may reduce biases associated with alcohol reporting. 22,26 While many studies have found correlations between alcohol consumption and a myriad of other variables, the evidence for associations between AUDIT and disposition in trauma patients is limited.…”

“… 18 – 20 Despite the self-report bias present in AUDIT, the survey has been shown to be a reliable and well-validated measure to assess habitual alcohol intake in patients. 21 – 25 Delivering the AUDIT test through a self-administered, computerized system has also been shown to be feasible and may reduce biases associated with alcohol reporting. 22 , 26 …”

Resilience to Hazardous Drinking Among Never‐Deployed Male United States Army Reserve and National Guard Soldiers

“…Second, all survey‐based research has the potential for response bias, but the use of confidential computer‐assisted interviewing methods has been shown to result in valid assessments of substance use (McNeely et al, 2016; Wolff and Shi, 2015). Further, computerized screenings for hazardous drinking have been shown to outperform traditional face‐to‐face methods (Imani et al, 2017). Third, being married or living as if married was an eligibility criterion for Operation: SAFETY, which may limit generalizability.…”

Alcohol use and smoking in burn patients at the Helsinki Burn Center

“…Drinking is considered hazardous when the AUDIT sum score for men is 8 and for women 6. These universal cut-off scores [2,[18][19][20] were used to separate the cohort according to baseline AUDIT sum scores to before the burn "at-risk drinkers" and "not at-risk drinkers" [21,22]. AUDIT was repeated at six months after burn.…”