Alcohol and Drug Use in Victims of Life-Threatening Trauma

Madan, Atul K.; Yu, Kathy Ka ying; Beech, Derrick J.

doi:10.1097/00005373-199909000-00026

Cited by 110 publications

(80 citation statements)

References 22 publications

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“…For example, pooled data on 4,063 patients treated at 6 regional trauma centers indicated that 40.2% of patients had a positive blood alcohol concentration at admission [5]; when polydrug use (alcohol, illicit drugs) was included, over 60% of the patients tested positive for intoxicants. [6] These findings reflect the results of Cromwell et al [7] who investigated the prevalence of substance use among victims of major trauma presenting to a Level I trauma center. Of the 516 patients who had urine toxicology and blood alcohol screens, 71% screened positive for alcohol or drugs or both: 52% had positive alcohol screens; and 42% had positive drug screens with cocaine and opiates representing 91% of positive drug screens.…”

Section: Substance Use and Injury Among Adultssupporting

confidence: 87%

Substance Use and Facial Injury

Murphy¹

2011

Perioperative Nursing Clinics

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Section: Substance Use and Injury Among Adultssupporting

confidence: 87%

Substance Use and Facial Injury

Murphy¹

2011

Perioperative Nursing Clinics

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“…12 Youth with assault-related injury are at high risk for reinjury. [13][14][15][16][17][18] Sims et al 19 found violently injured youth admitted to trauma units have readmission rates as high as 44% due to assault and 20% mortality due to homicide over a 5-year follow-up; retrospective chart reviews note similar rates. [19][20][21][22][23][24] The ED is the primary medical setting for injured adolescents, [25][26][27][28] and an important setting for violenceprevention programs.…”

mentioning

confidence: 99%

Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Violence involving firearms is a leading cause of death among US youth ages 14 to 24. The emergency department is the primary medical setting for care of assault-injured youth and an underused but important setting for violence-prevention programs.WHAT THIS STUDY ADDS: Among assault-injured youth seeking emergency department care, firearm possession rates are high, most obtained outside of legal channels. Higher rates of negative retaliatory attitudes and substance use among those youth with firearms increases risk of future lethal violence. abstract BACKGROUND AND OBJECTIVES: Firearm violence is a leading cause of death among youth. The objectives of this study were (1) determine firearm possession rates and associated correlates among youth seeking care for assault in an emergency department (ED); (2) understand differences in risk factors for youth with firearm possession; and (3) identify firearm possession characteristics in this population: type, reason for possession, and source of firearms. METHODS:Youth (14 to 24 years old) presenting to a Level 1 ED with assault were administered a computerized screening survey. Validated instruments were administered, measuring demographics, firearm rates and characteristics, attitudes toward aggression, substance use, and previous violence history.RESULTS: Among 689 assault-injured youth, 23% reported firearm possession in the past 6 months. Only 17% of those reporting firearm possession obtained the gun from a legal source; 22% reported ownership of highly lethal automatic/semiautomatic weapons and 37.1% reported having a firearm for protection. Logistic regression analysis identified significant correlates of firearm possession, including male gender, higher socioeconomic status, illicit drug use, recent serious fight, and retaliatory attitudes.CONCLUSIONS: ED assault-injured youth had high rates of firearm possession (23.1%), most of which were not obtained from legal sources. Youth with firearm possession were more likely to have been in a recent serious fight, and to endorse aggressive attitudes that increase their risk for retaliatory violence. Future prevention efforts should focus on minimizing illegal firearm access among high-risk youth, nonviolent alternatives to retaliatory violence, and substance use prevention. Dr Carter carried out the analyses, drafted the manuscript, and reviewed and revised the manuscript; Drs Walton and Zimmerman were responsible for the initial conceptualization and design of the study, design of data collection elements, and reviewed and revised the manuscript; Drs Newton and Whiteside assisted with the analysis, drafting of the manuscript, and critical review of the manuscript; Mr Clery assisted with the drafting of the manuscript and critical review of the manuscript; Dr Cunningham was responsible for the initial conceptualization and design of the study, design of data collection elements, aided in the analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript...

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“…3,4,17 In order to more definitively characterize the role of alcohol consumption in trauma, other studies have addressed injury at the level of the individual, analyzing serum alcohol and toxicology data from patient admissions. [18][19][20][21] This work has demonstrated higher odds ratios of trauma among those with elevated blood alcohol level upon hospital admission, particularly for head and facial trauma. Madan et al found that 80% of assault victims and 63% of those in motor-vehicle accidents admitted to a level 1 U.S. trauma center had positive serum ethanol screens, although this study found no significant difference in injury severity score (ISS), length of stay, or mortality between groups with positive and negative screens.…”

Section: Introductionmentioning

confidence: 72%

“…For those who were screened, mean BAL also did not vary among type of trauma or age group, as was expected given previous work linking alcohol availability to unintentional and intentional trauma among various age groups. 3,16,[18][19][20] The trend for increasing BAL during late-night hours (8 pm-6 am) was not significant, reinforcing the importance of a direct measure of alcohol use among trauma victims. Gruenewald and Ponicki and Livingston considered motor vehicle crashes or assaults in their respective studies to be alcohol related if they occurred after 8 pm, while our findings suggest a possible trend, it is clear that such a proxy is not adequate to determine the involvement of alcohol in trauma.…”

Section: Discussionmentioning

confidence: 93%

The Influence of Alcohol Outlets on Urban Trauma: A Pilot Study for Geospatial Modeling at a Fine Scale

Brondfield¹,

Sciortino²,

Juillard³

et al. 2016

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Background: The association between alcohol availability and injury is known. Our pilot study seeks to model rates of trauma at the individual and census tract level to better understand the role of alcohol outlets (AOs) relative to socioeconomic factors thought to influence injury. Correlating alcohol availability and injury in a multilevel model may better inform policy measures to prevent trauma and create a safer urban environment. Study design:Traumas in January-April 2013 (300 injury events) from an urban level 1 trauma center were analyzed with regard to injury severity score and blood alcohol level. Injury events and AO data acquired from the state Alcoholic Beverage Control were projected onto a map of census tracts, which included socioeconomic and demographic data from the U.S. Census Bureau (2009Bureau ( -2013. Traumas were stratified according to age, intentionality, and BAL screening. Ordinary least squares regression was performed to understand the relative contributions of AO, other dependent variables, and spatial autocorrelation.Results: Positive BAL screens were associated with higher ISS among trauma victims. At the census tract level, density of off-sale AO per capita was the strongest correlated variable with all traumas (R t 2 = 0.52, p < 0.01) and those for which BAL was elevated on admission (R t 2 = 0.74, p < 0.01). Violent trauma showed the strongest association with on-sale AO per capita (R vt 2 = 0.17). However, levels of spatial autocorrelation were Conclusion:Despite extensive autocorrelation among census tracts, preliminary modeling of trauma shows significant promise in better understanding the geospatial predictors of these events. While the influence of alcohol on trauma has been presumed in previous spatial analysis, this pilot represents a more robust approach through direct measures of BAL that can better inform understanding of spatial predictors for trauma.

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Alcohol and Drug Use in Victims of Life-Threatening Trauma

Abstract: These data suggest that alcohol and drug use is associated with life-threatening injury, especially intentional injury. Prevention of substance abuse is essential for the prevention of trauma.

Cited by 110 publications

References 22 publications

Substance Use and Facial Injury

Substance Use and Facial Injury

Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault

The Influence of Alcohol Outlets on Urban Trauma: A Pilot Study for Geospatial Modeling at a Fine Scale

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