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Article |

The Magnitude of Acute and Chronic Alcohol Abuse in Trauma Patients

Frederick P. Rivara, MD, MPH; Gregory J. Jurkovich, MD; James G. Gurney, MS, MSW; Debra Seguin, RN; Corinne L. Fligner, MD; Richard Ries, MD; Vidmantas A. Raisys, PhD; Michael Copass, MD
Arch Surg. 1993;128(8):907-913. doi:10.1001/archsurg.1993.01420200081015.
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Objective:  To assess the incidence of acute alcohol intoxication and the proportion of trauma patients with evidence of chronic alcohol abuse.

Design:  Prospective cohort study.

Setting:  Regional level I trauma center.

Participants:  Patients aged 18 years and older admitted with blunt or penetrating trauma.

Main Outcome Measures:  Admission blood alcohol concentrations (BACs), the Short Michigan Alcohol Screening Test (SMAST), and biochemical markers for chronic alcohol abuse.

Results:  Of the 2657 patients enrolled, 47.0% had a positive BAC and 35.8% were intoxicated (BAC ≥100 mg/dL) on admission to the emergency department. Intoxicated patients were more likely to be 25 to 34 years old, male, and nonwhite; the highest proportion of intoxicated patients was among victims of stab wounds. Three fourths of acutely intoxicated patients had evidence of chronic alcoholism as indicated by a positive SMAST, and 25% to 35% of acutely intoxicated patients had biochemical evidence of chronic alcohol abuse.

Conclusions:  The high prevalence of both acute intoxication and chronic alcoholism in trauma patients indicates the need to diagnose and appropriately treat this pervasive problem in trauma victims.(Arch Surg. 1993;128:907-913)


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