دورية أكاديمية
Implementation of mandatory blood alcohol screening in trauma patients: A retrospective study from a tertiary trauma center in a Middle Eastern country.
| العنوان: | Implementation of mandatory blood alcohol screening in trauma patients: A retrospective study from a tertiary trauma center in a Middle Eastern country. |
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| المؤلفون: | El-Menyar A; Trauma Surgery Section, Clinical Research, Hamad General Hospital (HGH), Doha, Qatar; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar. Electronic address: aymanco65@yahoo.com., Mekkodathil A; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar., Consunji R; Trauma Surgery Section, Injury Prevention Program, HGH, Doha, Qatar., Abeid A; Trauma Surgery Section, Injury Prevention Program, HGH, Doha, Qatar., Latifi R; Department of Surgery, Westchester Medical Center & New York Medical College, Valhalla, NY, United States., Rizoli S; Trauma Surgery Section, HGH, Doha, Qatar., Al-Thani H; Trauma Surgery Section, HGH, Doha, Qatar. |
| المصدر: | Alcohol (Fayetteville, N.Y.) [Alcohol] 2024 Sep; Vol. 119, pp. 7-15. Date of Electronic Publication: 2023 Dec 01. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 8502311 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-6823 (Electronic) Linking ISSN: 07418329 NLM ISO Abbreviation: Alcohol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York Ny : Elsevier Science Original Publication: Fayetteville, N.Y. : Ankho International, c1984- |
| مواضيع طبية MeSH: | Blood Alcohol Content* , Trauma Centers* , Wounds and Injuries*/blood , Wounds and Injuries*/epidemiology, Humans ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Alcohol Drinking/blood ; Young Adult ; Mass Screening/methods ; Adolescent ; Tertiary Care Centers ; Ethanol/blood |
| مستخلص: | Background: Alcohol consumption is a significant risk factor for several types of injuries and trauma recidivism and remains an important public health concern worldwide. We aimed to describe the implementation of mandatory alcohol screening and the AUDIT tool among trauma patients admitted to a level 1 trauma center in a country with a partial ban on alcohol consumption. Methods: This was a retrospective analysis of trauma patients (>12 years old) who required hospital admission and underwent blood alcohol concentration (BAC) screening between 2014 and 2019. This was achieved via an enzymatic method using alcohol dehydrogenase for ethanol detection in the plasma and serum samples. Trauma patients with a BAC <2.2 mmol/L were referred to as "negative", and BAC >2.2 mmol/L was referred to as "BAC positive". A comparative analysis was performed between the two BAC groups. Alcohol Screening, Brief Intervention, Referral for Treatment [ASBIRT] program, and AUDIT were applied. Results: A total of 7326 BAC screening tests were performed on 7284 patients during the study period. With slight variation over the years, the compliance rate was 77% (70.4%-85.3%), and the test positivity rate was 10% (8.6%-12.5%). There were 42 repeated admissions, of which seven patients were BAC positive at every admission. Young age and non-Arab patients were more likely to test positive, and the main mechanism of injury (MOI) was road traffic-related trauma (p < 0.05). Assault and self-inflicted injuries were significantly higher in BAC-positive patients than in BAC-negative patients (18% vs. 4% and 2.7% vs. 1.3%, respectively; p = 0.001). The injury severity score (ISS) and mortality rate were comparable between the study groups. Patients with a positive BAC were significantly more likely to undergo pan-CT scan in the emergency department, intubation, and exploratory laparotomy than those with a negative BAC. In patients who sustained injuries due to assault, all-terrain vehicles, or motorcycle crashes, there was a significant association between the positivity of BAC tests and the patient's ISS. Conclusion: Despite improvements in BAC screening in trauma admissions over the years, almost 20% of cases were missed. Although the mortality rates were comparable, alcohol consumption burdens resources in terms of excess imaging, intubation, open abdominal surgery, and possible disability. Further studies are needed to understand the key obstacles and challenges to achieving optimum compliance for screening in trauma settings. Competing Interests: Declaration of competing interest None. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: AUDIT; BAC; Middle East; alcohol; compliance; mortality; policy; trauma |
| المشرفين على المادة: | 0 (Blood Alcohol Content) 3K9958V90M (Ethanol) |
| تواريخ الأحداث: | Date Created: 20231203 Date Completed: 20240801 Latest Revision: 20240801 |
| رمز التحديث: | 20240802 |
| DOI: | 10.1016/j.alcohol.2023.11.009 |
| PMID: | 38043650 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1873-6823 |
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| DOI: | 10.1016/j.alcohol.2023.11.009 |