ANALYSIS OF ALCOHOL-USE CLUSTERS AMONG SUBCRITICALLY INJURED EMERGENCY DEPARTMENT PATIENTS

Objectives: 1) To cluster patients according to self-reported drinking patterns using cluster analysis; 2) to externally validate clustered groups on variables related to drinking but not used in the cluster an alysis; and 3) to use the clustered patients' responses to alcohol con sumption questions to develop a brief screening tool emergency physici ans can use to identify patients in need of referral or intervention r elated to potentially hazardous alcohol consumption. Methods: A self-r eport battery was administered to 95 subcritically injured patients. P atients also were saliva alcohol-tested upon arrival to the ED. Using the patients' self-reported quantity, frequency of alcohol consumption , and frequency of having greater than or equal to 6 drinks on a drink ing occasion, patients were categorized into 3 groups using cluster an alysis. The 3 clusters were externally validated using injury-related variables, alcohol-related consequences, and, the patients' reported r eadiness to change drinking. A screening tool was developed using cuto ff values reported by the patients' answers to drinking pattern questi ons. Results: Fifty-nine patients were alcohol-negative, and 36 tested alcohol-positive (i.e., >4 mmol/L [>20 mg/ dL]) or had elevated score s on an alcohol problem screening instrument. Three distinct drinking pattern clusters were found. Clusters were validated using discriminan t function analysis and multivariate analyses of variance to confirm c luster classifications. Steady and high-intensity drinkers reported mo re alcohol-related negative consequences, and high-intensity drinkers indicated they would consider changing their drinking. The screening t ool correctly classified 97% of the patient sample into their respecti ve clusters. Conclusions: Using the drinking pattern questions in the clustering procedure was effective for grouping injured patients into clusters that could be differentiated on other drinking-related variab les. The resulting screening tool can be used in the ED setting to scr een patients for further assessment and intervention. The readiness-to -change results support the assertion that the injury event provides a ''teachable moment'' for subcritically injured patients whose injury may be related to their alcohol consumption.