RISK-TAKING BEHAVIORS AMONG ADOLESCENT TRAUMA PATIENTS

Background: Alcohol is a major contributing factor in adult trauma and may adversely affect decision-making in other safety areas such as us e of seatbelts and motorcycle helmets, The magnitude of risk-taking be havior and poor decision-making among adolescent trauma patients is no t fully appreciated, Our objective was to determine the prevalence and pattern of risk-taking behavior among adolescents (age less than or e qual to 20 years) admitted to an adult Level I trauma center, Methods: The trauma registry was used to identify patients, Data collected inc luded age, mechanism of injury, blood alcohol and urine toxicology res ults, seatbelt and helmet use, Glasgow Coma Score, Injury Severity Sco re, and outcome.Results: Fifteen percent of all admissions to an adult trauma center were adolescents (648 of 4,291), Twenty-one percent of adolescents (138 of 648) and 30% of adults (1,067 of 3,643) tested pos itive for blood alcohol on admission, Seatbelts were worn by only 19% of adolescent motor vehicle crash admissions versus 30% of adults, Onl y 7% of adolescents (6 of 83) with detectable alcohol used restraints, compared with 22% (67 of 310) without documented alcohol ingestion (p < 0.05), Adults were somewhat better at restraint use (16% of alcohol -positive patients and 36% without alcohol), Eight of 23 minors (35%) in motorcycle/bicycle crashes were wearing a helmet, compared with 95 of 168 adults (57%), Overall, 6.7% of adolescents and 8.6% of adults h ad positive toxicology screens, Adolescents with known alcohol consump tion were twice as likely to have a positive toxicology screen for ill egal drugs (15 vs, 7%;p < 0.05), Alcohol was also frequently detected among adolescents with mechanisms of injury other than motor vehicle a nd motorcycle crashes, such as violence (25%) and falls (44%). Conclus ion: Alcohol is frequently involved in all types of trauma, for adoles cents as well as adults, This is often compounded by poor decision-mak ing and multiple risk-taking behaviors.