This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

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.

Abstract
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 -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)

Author Affiliations
From Harborview Injury Prevention and Research Center, Seattle, Wash (Drs Rivara, Koepsell, and Jurkovich and Messrs Gurney and Soderberg), and the Departments of Epidemiology (Drs Rivara and Koepsell and Mr Gurney), Pediatrics (Dr Rivara), Health Services (Dr Koepsell), and Surgery (Dr Jurkovich), University of Washington, Seattle.

Footnotes
Reprint requests to Harborview Injury Prevention and Research Center, 325 Ninth Ave, ZX-10, Seattle, WA 98104-2499 (Dr Rivara).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A 74-Year-Old Man With Memory Loss and Neuropathy Who Enjoys Alcoholic Beverages
Brust
JAMA 2008;299:1046-1054.
ABSTRACT | FULL TEXT  

Impact of Problem Alcohol Use on Patient Behavior and Caregiver Burden in a Geriatric Assessment Clinic
Pirzada Sattar et al.
J Geriatr Psychiatry Neurol 2007;20:120-127.
ABSTRACT  

Understanding the health impact of alcohol dependence
Cargiulo
Am J Health Syst Pharm 2007;64:S5-S11.
ABSTRACT | FULL TEXT  

Posttraumatic Stress and Depressive Symptoms, Alcohol Use, and Recurrent Traumatic Life Events in a Representative Sample of Hospitalized Injured Adolescents and Their Parents
Zatzick et al.
J Pediatr Psychol 2006;31:377-387.
ABSTRACT | FULL TEXT  

Ethanol Blocks Leukocyte Recruitment and Endothelial Cell Activation In Vivo and In Vitro
Saeed et al.
J. Immunol. 2004;173:6376-6383.
ABSTRACT | FULL TEXT  

DRINKING PATTERNS AND PROBLEMS IN EMERGENCY SERVICES IN POLAND
Cherpitel et al.
Alcohol Alcohol 2004;39:256-261.
ABSTRACT | FULL TEXT  

A Randomized Effectiveness Trial of Stepped Collaborative Care for Acutely Injured Trauma Survivors
Zatzick et al.
Arch Gen Psychiatry 2004;61:498-506.
ABSTRACT | FULL TEXT  

Predictors of Future Fight-Related Injury Among Adolescents
Borowsky and Ireland
Pediatrics 2004;113:530-536.
ABSTRACT | FULL TEXT  

"Nurse, I Only Had a Couple of Beers": Validity of Self-reported Drinking Before Serious Vehicular Injury
Sommers et al.
Am J Crit Care 2002;11:106-114.
ABSTRACT | FULL TEXT  

Posttraumatic Stress, Problem Drinking, and Functional Outcomes After Injury
Zatzick et al.
Arch Surg 2002;137:200-205.
ABSTRACT | FULL TEXT  

Intoxicated Motor Vehicle Passengers: An Overlooked At-Risk Population
Schermer et al.
Arch Surg 2001;136:1244-1248.
ABSTRACT | FULL TEXT  

Outpatient Management of Patients with Alcohol Problems
Fiellin et al.
ANN INTERN MED 2000;133:815-827.
ABSTRACT | FULL TEXT  

Toxicological screening in trauma
Carrigan et al.
Emerg. Med. J. 2000;17:33-37.
ABSTRACT | FULL TEXT  

Alcohol and other psychoactive drugs in trauma patients aged 10-14 years
Li et al.
Inj. Prev. 1999;5:94-97.
ABSTRACT | FULL TEXT  

Patients with Alcohol Problems
O'Connor and Schottenfeld
NEJM 1998;338:592-602.
FULL TEXT  

Injury Prevention- First of Two Parts
Rivara et al.
NEJM 1997;337:543-548.
FULL TEXT  

Psychoactive Substance Use Disorders Among Seriously Injured Trauma Center Patients
Soderstrom et al.
JAMA 1997;277:1769-1774.
ABSTRACT  

Alcohol Interventions in Trauma Centers: Current Practice and Future Directions
Gentilello et al.
JAMA 1995;274:1043-1048.
ABSTRACT  

Alcohol and Injuries: Time for Action
Arch Fam Med 1995;4:499-501.
ABSTRACT  

Serum Cholesterol Level and Mortality Due to Suicide and Trauma in the Honolulu Heart Program
Iribarren et al.
Arch Intern Med 1995;155:695-700.
ABSTRACT  

Addiction Medicine
Franklin
JAMA 1994;271:1650-1651.
ABSTRACT  

Emergency Medicine
Sklar
JAMA 1994;271:1665-1666.
ABSTRACT