THE MAGNITUDE OF ACUTE AND CHRONIC ALCOHOL-ABUSE IN TRAUMA PATIENTS

Objective: To assess the incidence of acute alcohol intoxication and t he proportion of trauma patients with evidence of chronic alcohol abus e. Design: Prospective cohort study. Setting: Regional level I trauma center. Participants: Patients aged 18 years and older admitted with b lunt or penetrating trauma. Main Outcome Measures: Admission blood alc ohol concentrations (BACs), the Short Michigan Alcohol Screening Test (SMAST), and biochemical markers for chronic alcohol abuse. Results: O f the 2657 patients enrolled, 47.0% had a positive BAC and 35.8% were intoxicated (BAC greater-than-or-equal-to 100 mg/dL) on admission to t he emergency department. Intoxicated patients were more likely to be 2 5 to 34 years old, male, and nonwhite; the highest proportion of intox icated patients was among victims of stab wounds. Three fourths of acu tely intoxicated patients had evidence of chronic alcoholism as indica ted by a positive SMAST, and 25% to 35% of acutely intoxicated patient s had biochemical evidence of chronic alcohol abuse. Conclusions: The high prevalence of both acute intoxication and chronic alcoholism in t rauma patients indicates the need to diagnose and appropriately treat this pervasive problem in trauma victims.