Document Detail


Implications of formal alcohol screening in burn patients.
MedLine Citation:
PMID:  19060726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of this study was to screen burn patients for alcohol use disorders to identify those at increased risk for repeat injury and adverse effects of alcohol use. We examined associations of at-risk drinking and dependence symptoms as measured by a formal screening tool and blood alcohol concentration (BAC) to guide further screening, treatment, and research. We hypothesized that the majority of drinkers would not have symptoms of alcohol dependence, that BAC would be inadequate to screen for alcohol disorders, and that at-risk drinkers would be more likely to be unemployed and uninsured than healthy drinkers. Formal screening of English speakers, age 16 to 75, admitted to the burn service for over 24 hours was conducted for a 6-month period, using the Alcohol Use Disorders Identification Test. Of the 123 patients eligible for the study, 110 (89.4%) were approached for formal screening, four refused (3.6%), and 13 were missed (10.6%). BAC was obtained in 68 of 110 (61.8%); no patient who reported abstinence had a positive BAC. Of the 106 screened, 34.9% were nondrinkers, 11.3% drank daily or almost daily, and 28.3% binge drank at least monthly (>4 drinks per occasion for men, >3 for women). Of the patients who drank, only eight patients reported one or more sign of dependence in the last year (11.6%). For the group as a whole, 20.9% met Alcohol Use Disorders Identification Test criteria for at-risk drinking, with an average BAC of 39.8 mg/dl, (range 0-242 mg/dl). Using BAC of >or=80 mg/dl, only 5.6% of patients would have been identified as at-risk drinkers. Twenty-three percent of patients had no health insurance, 36% of whom were at-risk drinkers compared with 17.3% of insured patients (P < .05). For the group as a whole, 41.8% of patients were unemployed. At-risk drinking did not differ between employed and unemployed patients (24.6% vs 17.8%, P > .05). Among burn patients, formal alcohol screening identified that one in five patients is at risk for further problems from their drinking and that most at-risk drinkers are binge drinkers and do not show signs of dependency. Formal screening identified more at-risk drinkers than BAC. Implications of the screening findings are 1) because most burn patients who drink are binge but not dependent drinkers, alcohol withdrawal should be infrequent, and 2) animal models of alcohol use and burn injury should study acute intoxication and binge exposure. In addition, 3) we would expect burn patients to respond to brief interventions for alcohol use disorders similar to trauma and primary care patients.
Authors:
Joslyn M Albright; Elizabeth J Kovacs; Richard L Gamelli; Carol R Schermer
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of burn care & research : official publication of the American Burn Association     Volume:  30     ISSN:  1559-047X     ISO Abbreviation:  J Burn Care Res     Publication Date:    2009 Jan-Feb
Date Detail:
Created Date:  2009-01-12     Completed Date:  2009-03-06     Revised Date:  2010-09-22    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  62-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Burn and Shock Trauma Institute, Loyola University Medical Center, Maywood, Illinois 60153, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Alcohol Drinking / epidemiology*,  prevention & control
Burns*
Chi-Square Distribution
Female
Humans
Illinois / epidemiology
Male
Mass Screening
Middle Aged
Nursing Assessment
Prospective Studies
Risk Assessment
Risk-Taking
Grant Support
ID/Acronym/Agency:
R01 AA012034/AA/NIAAA NIH HHS; R01 AA015067/AA/NIAAA NIH HHS; T32 GM08750/GM/NIGMS NIH HHS
Comments/Corrections

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