Adolescent injury in the emergency department: Opportunity for alcohol interventions?

Study objective: Alcohol, the most commonly used substance among adolescent s, is frequently associated with injury. Little is known regarding the drin king characteristics of injured adolescents. Such data are critical for dev eloping emergency department interventions to decrease alcohol-related inju ry among adolescents. We sought to describe the drinking characteristics of injured adolescents and to describe the relationship of injury severity an d mechanisms with drinking characteristics. Methods: This study was a prospective cohort study performed in a universit y hospital (sampled May 1, 1995, to July 15, 1995) and a large urban teachi ng hospital (sampled May 1, 1996, to August 1, 1996). The participants were aged 12 to 20 years, presenting within 6 hours of an injury. We performed a saliva alcohol test and self-administered questionnaire. Age, sex, E-code , injury severity score (ISS), and ED disposition were recorded. An alcohol frequency/quantity index was calculated. Descriptive statistics and 95% co nfidence intervals were calculated. Results: Two hundred sixty-three patients with a mean age of 17 years and a mean ISS of 2.1 (SD 3.5) were recruited. One hundred fifty-two (50%) were males, and 33 (13%) were admitted. Ten (4%) patients had a positive saliva alcohol test response. On average, within the last year, these adolescents had 1.7 adverse alcohol consequences. Sixty percent drank in unsupervised s ettings, and 36% reported drinking 5 or more drinks in a row. Conclusion: Alcohol use/misuse is a substantial problem among injured adole scents regardless of severity or mechanism of injury. ED physicians should consider screening/intervention or primary prevention of alcohol problems f or all injured adolescents.