Drinking Modification Begins in Trauma Unit

Article excerpt

CHICAGO -- Admission to a trauma unit may represent a "teachable moment" for alcohol-dependent patients that may be missed if their wounds are repaired and they're simply sent on their way, Dr. Donald N. Reed Jr. said at the annual clinical congress of the American College of Surgeons.

Results of a preliminary study by Dr. Reed and his associates at the trauma unit of McLaren Regional Medical Center in Flint, Mich., suggest that some trauma victims with alcohol problems may be open to behavior intervention during their recovery.

Better communication between trauma surgeons and other physicians might foster the sort of follow-up that could end a cycle of dangerous drinking behavior in motivated patients, he said.

Alcohol-dependent trauma patients have been previously shown to be at increased odds of readmission for subsequent trauma, making prevention a key goal, Dr. Reed said.

The Michigan State University study involved 100 consecutive patients admitted for trauma care over a 14-month period.

Among 97 for whom blood alcohol testing results were available, 42 had been drinking, with a mean blood alcohol level of 184 mg/dL, and a range of 10-537 mg/dL. (A blood alcohol level of 50 mg/dL is associated with obvious intoxication and impaired judgment and reflexes.)

The patients, when stabilized, were administered three psychological screening instruments aimed at assessing the severity of their drinking behavior and willingness to change that behavior: the CAGE questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and a short form of the Stages of Change test.

Well over half of the males (19 of 29) who had been drinking had scores on both CAGE and AUDIT that suggested harmful drinking behavior. Fewer females had harmful behavior scores on the CAGE test, but nearly half (6 of 13) had elevated scores on AUDIT, which is known to be more sensitive in women. …