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Titolo:
Detection of acute alcohol intoxication and chronic alcohol dependence by trauma center staff
Autore:
Gentilello, LM; Villaveces, A; Ries, RR; Nason, KS; Daranciang, E; Donovan, DM; Copass, M; Jurkovich, GJ; Rivara, FP;
Indirizzi:
Univ Washington, Harborview Med Ctr, Sch Med, Dept Surg, Seattle, WA 98104USA Univ Washington Seattle WA USA 98104 Med, Dept Surg, Seattle, WA 98104USA Univ Washington, Sch Med, Dept Pediat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 , Dept Pediat, Seattle, WA 98195 USA Univ Washington, Sch Med, Dept Psychiat, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Dept Psychiat, Seattle, WA 98195 USA Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA Univ WashingtonSeattle WA USA 98195 Med, Dept Med, Seattle, WA 98195 USA Univ Washington, Inst Alcohol & Drug Abuse, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 & Drug Abuse, Seattle, WA 98195 USA
Titolo Testata:
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
fascicolo: 6, volume: 47, anno: 1999,
pagine: 1131 - 1135
Fonte:
ISI
Lingua:
ENG
Soggetto:
BRIEF INTERVENTIONS; CAGE QUESTIONNAIRE; ABDOMINAL-TRAUMA; SCREENING-TEST; ABUSE; DRINKERS; TRIAL;
Keywords:
trauma centers; traumatology; injuries; alcohol; alcoholism; intervention studies; public health;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Gentilello, LM Univ Washington, Harborview Med Ctr, Sch Med, Dept Surg, Box 359796,325 9th Ave, Seattle, WA 98104 USA Univ Washington Box 359796,325 9th Ave Seattle WA USA 98104
Citazione:
L.M. Gentilello et al., "Detection of acute alcohol intoxication and chronic alcohol dependence by trauma center staff", J TRAUMA, 47(6), 1999, pp. 1131-1135

Abstract

Background: Trauma patients with acute alcohol intoxication or chronic alcohol dependence are at greater risk for morbidity and mortality. We hypothesized that relying on clinical suspicion to detect acute alcohol intoxication and chronic alcohol dependence in trauma patients is inaccurate, influenced by injury factors, and biased by race, gender, age, and socioeconomic status. Methods: Trauma patients were screened with a blood alcohol concentration and with the Short Michigan Alcohol Screening Test and CAGE questionnaire. Before screening, physicians and emergency department nurses were asked whether the patient was acutely intoxicated (blood alcohol concentration > 100mg/dL) or had a chronic alcohol problem. Sensitivity, specificity, positive, and negative predictive values were determined by comparing responses with blood alcohol concentration, Short Michigan Alcohol Screening Test, and CAGE questionnaire results, stratified by injury and demographic factors. Results: Clinical evaluations were obtained on 462 patients. Overall, 23% of acutely intoxicated patients were not identified by physicians. The missrate increased to one third in severely injured, chemically paralyzed, or intubated patients. Specificity was also poor. Patients with a negative blood alcohol concentration were more likely to be falsely suspected of intoxication if they were either young, male, perceived as disheveled, uninsured,or having a low income (p < 0.05). Staff identified < 50% of patients witha positive Short Michigan Alcohol Screening Test or CAGE, and falsely identified 26% of patients as alcoholic,Conclusions: Formal alcohol screening should be routine because clinical detection of acute alcohol intoxication and dependence is inaccurate. Screening should also be routine to avoid discriminatory bias attributable to patient characteristics.

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Documento generato il 31/03/20 alle ore 10:19:31