دورية أكاديمية
Hospital variability in adoption of alcohol and drug screening in adult trauma patients.
| العنوان: | Hospital variability in adoption of alcohol and drug screening in adult trauma patients. |
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| المؤلفون: | Silver CM; From the Department of Surgery (C.M.S., M.R.V., S.R., A.M.S.), Northwestern University Feinberg School of Medicine; American College of Surgeons (A.C.T.), Chicago, Illinois, Department of Surgery (A.C.T.), Medical College of Wisconsin, Milwaukee, Wisconsin; and Department of Emergency Medicine (M.C.R., H.K.K.) and Department of Surgery (R.E.P.), University of California San Francisco, San Francisco, California., Visenio MR, Thomas AC, Reddy S, Raven MC, Kanzaria HK, Plevin RE, Stey AM |
| المصدر: | The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2023 May 01; Vol. 94 (5), pp. 684-691. Date of Electronic Publication: 2023 Feb 20. |
| نوع المنشور: | Journal Article; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins |
| مواضيع طبية MeSH: | Substance-Related Disorders*/diagnosis , Substance-Related Disorders*/epidemiology , Substance Abuse Detection*, Adult ; Humans ; Cross-Sectional Studies ; Ethanol ; Hospitals ; Retrospective Studies ; Trauma Centers ; Wounds and Injuries/diagnosis |
| مستخلص: | Background: Despite recommendations to screen all injured patients for substance use, single-center studies have reported underscreening. This study sought to determine if there was significant practice variability in adoption of alcohol and drug screening of injured patients among hospitals participating in the Trauma Quality Improvement Program. Methods: This was a retrospective observational cross-sectional study of trauma patients 18 years or older in Trauma Quality Improvement Program 2017-2018. Hierarchical multivariable logistic regression modeled the odds of screening for alcohol and drugs via blood/urine test while controlling for patient and hospital variables. We identified statistically significant high and low-screening hospitals based on hospitals' estimated random intercepts and associated confidence intervals (CIs). Results: Of 1,282,111 patients at 744 hospitals, 619,423 (48.3%) were screened for alcohol, and 388,732 (30.3%) were screened for drugs. Hospital-level alcohol screening rates ranged from 0.8% to 99.7%, with a mean rate of 42.4% (SD, 25.1%). Hospital-level drug screening rates ranged from 0.2% to 99.9% (mean, 27.1%; SD, 20.2%). A total of 37.1% (95% CI, 34.7-39.6%) of variance in alcohol screening and 31.5% (95% CI, 29.2-33.9%) of variance in drug screening were at the hospital level. Level I/II trauma centers had higher adjusted odds of alcohol screening (adjusted odds ratio [aOR], 1.31; 95% CI, 1.22-1.41) and drug screening (aOR, 1.16; 95% CI, 1.08-1.25) than Level III and nontrauma centers. We found 297 low-screening and 307 high-screening hospitals in alcohol after adjusting for patient and hospital variables. There were 298 low-screening and 298 high-screening hospitals for drugs. Conclusion: Overall rates of recommended alcohol and drug screening of injured patients were low and varied significantly between hospitals. These results underscore an important opportunity to improve the care of injured patients and reduce rates of substance use and trauma recidivism. Level of Evidence: Prognostic and Epidemiological; Level III. (Copyright © 2023 American Association for the Surgery of Trauma.) |
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| معلومات مُعتمدة: | K23 HL157832 United States HL NHLBI NIH HHS; T32 CA247801 United States CA NCI NIH HHS |
| المشرفين على المادة: | 3K9958V90M (Ethanol) |
| تواريخ الأحداث: | Date Created: 20230221 Date Completed: 20230922 Latest Revision: 20240502 |
| رمز التحديث: | 20240502 |
| مُعرف محوري في PubMed: | PMC10133007 |
| DOI: | 10.1097/TA.0000000000003928 |
| PMID: | 36801898 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2163-0763 |
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| DOI: | 10.1097/TA.0000000000003928 |