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The Effects of Alcohol Abuse on Readmission for Trauma

Frederick P. Rivara, MD, MPH; Thomas D. Koepsell, MD, MPH; Gregory J. Jurkovich, MD; James G. Gurney, MSW, MS; Robert Soderberg
JAMA. 1993;270(16):1962-1964. doi:10.1001/jama.1993.03510160080033.
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Objective.  —To determine the effect of admission for trauma with concurrent acute alcohol intoxication or chronic alcohol abuse on the risk of subsequent recurrence of trauma.

Design.  —Prospective cohort study.

Setting.  —Level I regional trauma center.

Patients.  —A total of 2578 patients 18 years or older admitted with blunt or penetrating trauma within 24 hours of injury and surviving to discharge. All patients had a blood alcohol concentration (BAC) test, a γ-glutamyltransferase (GGT) test, and the short Michigan Alcohol Screening Test (SMAST) performed on admission.

Main Outcome Measurement.  —Readmission to the trauma center for new trauma. Average follow-up was 28 months (range, 16 to 40 months).

Results.  —The overall rate of readmission for new injuries was 1.3 per 1000 patient-months of follow-up. Patients who were intoxicated on the initial admission (BAC >22 mmol/L [100 mg/dL]) were 2.5-fold as likely to be readmitted than those not intoxicated (95% confidence limits, 1.6, 3.9). The relative risks for patients with positive SMAST scores and abnormal GGT values were 2.2 (95% confidence limits, 1.4, 3.5) and 3.5 (95% confidence limits, 2.2, 5.5), respectively. The increased risks remained significant for intoxication and abnormal GGT values after adjustment for gender, race, Medicaid status, and mechanism of injury.

Conclusion.  —Alcohol abuse is associated with an increased risk of readmission for new trauma. Trauma patients should be screened for alcohol problems; referral of problem drinkers for appropriate care may decrease their risk of admission for subsequent trauma.(JAMA. 1993;270:1962-1964)


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