The effects of alcohol abuse on readmission for trauma

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Abstract
I regional trauma center. Patients.\p=m-\Atotal of 2578 patients 18 years or older admitted with blunt or pen- etrating trauma within 24 hours of injury and surviving to discharge. All patients had a blood alcohol concentration (BAC) test, a \g=g\-glutamyltransferase(GGT) test, and the short Michigan Alcohol Screening Test (SMAST) performed on admission. Main Outcome Measurement.\p=m-\Readmissionto the trauma center for new trauma. Average follow-up was 28 months (range, 16 to 40 months). Results.\p=m-\Theoverall rate of readmission for new injuries was 1.3 per 1000 patient-months of follow-up. Patients who were intoxicated on the initial admission (BAC >22 mmol/L (100 mg/dL)) were 2.5-fold as likely to be readmitted than those not intoxicated (95% confidence limits, 1.6, 3.9). The relative risks for patients with positive SMAST scores and abnormal GGT values were 2.2 (95% confidence lim- its, 1.4, 3.5) and 3.5 (95% confidence limits, 2.2, 5.5), respectively. The increased risks remained significant for intoxication and abnormal GGT values after adjust- ment for gender, race, Medicaid status, and mechanism of injury. Conclusion.\p=m-\Alcoholabuse is associated with an increased risk of readmission for new trauma. Trauma patients should be screened for alcohol problems; referral of problem drinkers for appropriate care may decrease their risk of admission for subsequent trauma. (JAMA. 1993;270:1962-1964)

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