Alcohol and injury in adolescents

Objective: To determine the frequency of alcohol ingestion in adolescent vi ctims of major trauma and determine whether alcohol ingestion is associated with increased injury severity or death. Methods: Subjects mere all patients between 12-25 years of age treated at P ennsylvania trauma centers in 1996 who were reported to the state trauma da tabase. Data on age, mechanism of injury (E-code), blood alcohol concentrat ion (BAC), Injury Severity Score (ISS), and survival mere obtained from the state database. BAC positive and negative patients within three groups: ag es 12-17, 18-20, and 21-25, were compared to determine any difference in de ath rate, injury severity or type of injury, Results: 4309 patients aged 12-25 were reported to the state in 1996, 2724 (63.2%) underwent testing for BAG, with 883 (32.5%) of those tested being p ositive. Testing positive were: 93/726 (12.8%) between 12-17 years old, 249 /844 (29.5%) between 18-20 Sears old, and 542/1154(47.0%) between 21-25 yea rs old. 567/884 (64.1%) of those testing positive had BAC greater than or e qual to 100 mg/dl. There were no statistically significant differences in m ean ISS or death rate between BAC negative and BAC positive patients in eit her of the age groups. Regression analysis also showed no relationship betw een mortality and either the presence of alcohol or the actual level of BAC . Other regression analysis demonstrated a slight downward trend for ISS wi th increasing intoxication, which mas statistically significant at P < 0.01 . Conclusions: Alcohol ingestion is found even in early adolescent trauma pat ients and is seen to increase throughout the teenage years, occurring in ov er one-quarter of patients 18 to 20 years of age. Suspicion must be high th at ingestion of alcohol has occurred in adolescent trauma. Further efforts should be made to improve the rate of testing in late adolescents, to ensur e adequate identification of an alcohol-exposed patients and enable educati onal interventions. No significant differences in mortality mere seen betwe en alcohol positive and negative patients, but there was a trend to decreas ed injury severity with the presence of alcohol.