Screening trauma patients for Alcoholism according to NIAAA guidelines with Alcohol Use disorders identification Test questions

• Published in: Alcoholism, clinical and experimental research Vol. 22; no. 7; pp. 1470 - 1475
• Main Authors: SODERSTROM, C. A, DISCHINGER, P. C, KERNS, T. J, KUFERA, J. A, MCDUFF, D. R, GORELICK, D. A, SMITH, G. S
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Baltimore, MD Lippincott Williams & Wilkins 01.10.1998
• Subjects: Accidents, Traffic - statistics & numerical data; Adult; Aged; Alcohol-Related Disorders - diagnosis; Alcohol-Related Disorders - epidemiology; Alcoholism - diagnosis; Alcoholism - epidemiology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Female; Humans; Male; Maryland - epidemiology; Mass Screening - statistics & numerical data; Medical sciences; Middle Aged; Practice Guidelines as Topic; Reproducibility of Results; Toxicology; Violence - statistics & numerical data; Wounds and Injuries - diagnosis; Wounds and Injuries - epidemiology; Maryland; Consumption; Human; Accident; Ethanol; Alcoholism; Administration schedule; Hospital; Medical screening; Traumatology; Epidemiology; Trauma; Public health
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1097/00000374-199810000-00015

Drinking pattern criteria (drinking frequency and number of drinks per occasion) issued by the National Institute on Alcohol and Abuse and Alcoholism (NIAAA) to screen primary practice patients for alcohol problems were evaluated in 1216 injured patients treated in a regional trauma center. Vehicular crash victims predominated (50.2%, of whom 64.5% were drivers), followed by victims of violence (31.2%) and nonviolent-injury victims (18.5%). Alcohol Use Disorders Identification Test (AUDIT) questions #1 (drinking frequency) and #2 (drinks/day) were used to assess the patients for current alcohol dependence (CAD). AUDIT responses roughly approximating NIAAA guidelines (high threshold: drinks > or = 4 times/week, > or = 5 drinks/day) and those indicating less drinking (low threshold: drinks > or = 2-3 times/ week, > or = 3 drinks/day) were chosen. Comparisons were made relative to sensitivity and specificity of responses in detecting CAD. When low threshold responses were used for either question, sensitivity to detect CAD increased overall (#1 from 0.53 to 0.80, #2 from 0.62 to 0.88) as well as among the subgroups of patients, whereas specificity remained high or at acceptable levels overall (#1 from 0.95 to 0.82, #2 from 0.92 to 0.71) and among the subgroups of patients. Study findings suggest that, among injured drivers and other groups of trauma center patients, lesser amounts of drinking should be used as screening criteria for CAD than are used for the general population.