Implications of formal alcohol screening in burn patients

Joslyn M. Albright, Elizabeth J. Kovacs, Richard L. Gamelli, Carol R. Schermer

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

The purpose of this study was to screen burn patients for alcohol use disorders to identify those at increased risk for repeat injury and adverse effects of alcohol use. We examined associations of at-risk drinking and dependence symptoms as measured by a formal screening tool and blood alcohol concentration (BAC) to guide further screening, treatment, and research. We hypothesized that the majority of drinkers would not have symptoms of alcohol dependence, that BAC would be inadequate to screen for alcohol disorders, and that at-risk drinkers would be more likely to be unemployed and uninsured than healthy drinkers. Formal screening of English speakers, age 16 to 75, admitted to the burn service for over 24 hours was conducted for a 6-month period, using the Alcohol Use Disorders Identification Test. Of the 123 patients eligible for the study, 110 (89.4%) were approached for formal screening, four refused (3.6%), and 13 were missed (10.6%). BAC was obtained in 68 of 110 (61.8%); no patient who reported abstinence had a positive BAC. Of the 106 screened, 34.9% were nondrinkers, 11.3% drank daily or almost daily, and 28.3% binge drank at least monthly (>4 drinks per occasion for men, >3 for women). Of the patients who drank, only eight patients reported one or more sign of dependence in the last year (11.6%). For the group as a whole, 20.9% met Alcohol Use Disorders Identification Test criteria for at-risk drinking, with an average BAC of 39.8 mg/dl, (range 0-242 mg/dl). Using BAC of ≥80 mg/dl, only 5.6% of patients would have been identified as at-risk drinkers. Twenty-three percent of patients had no health insurance, 36% of whom were at-risk drinkers compared with 17.3% of insured patients (P <.05). For the group as a whole, 41.8% of patients were unemployed. At-risk drinking did not differ between employed and unemployed patients (24.6% vs 17.8%, P >.05). Among burn patients, formal alcohol screening identified that one in five patients is at risk for further problems from their drinking and that most at-risk drinkers are binge drinkers and do not show signs of dependency. Formal screening identified more at-risk drinkers than BAC. Implications of the screening findings are 1) because most burn patients who drink are binge but not dependent drinkers, alcohol withdrawal should be infrequent, and 2) animal models of alcohol use and burn injury should study acute intoxication and binge exposure. In addition, 3) we would expect burn patients to respond to brief interventions for alcohol use disorders similar to trauma and primary care patients.

Original languageEnglish (US)
Pages (from-to)62-69
Number of pages8
JournalJournal of Burn Care and Research
Volume30
Issue number1
DOIs
StatePublished - Jan 2009
Externally publishedYes

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Alcohols
Drinking
Wounds and Injuries
Health Insurance
Blood Alcohol Content
Alcoholism
Primary Health Care
Animal Models
Research

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Albright, J. M., Kovacs, E. J., Gamelli, R. L., & Schermer, C. R. (2009). Implications of formal alcohol screening in burn patients. Journal of Burn Care and Research, 30(1), 62-69. https://doi.org/10.1097/BCR.0b013e3181921f31

Implications of formal alcohol screening in burn patients. / Albright, Joslyn M.; Kovacs, Elizabeth J.; Gamelli, Richard L.; Schermer, Carol R.

In: Journal of Burn Care and Research, Vol. 30, No. 1, 01.2009, p. 62-69.

Research output: Contribution to journalArticle

Albright, JM, Kovacs, EJ, Gamelli, RL & Schermer, CR 2009, 'Implications of formal alcohol screening in burn patients', Journal of Burn Care and Research, vol. 30, no. 1, pp. 62-69. https://doi.org/10.1097/BCR.0b013e3181921f31
Albright, Joslyn M. ; Kovacs, Elizabeth J. ; Gamelli, Richard L. ; Schermer, Carol R. / Implications of formal alcohol screening in burn patients. In: Journal of Burn Care and Research. 2009 ; Vol. 30, No. 1. pp. 62-69.
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abstract = "The purpose of this study was to screen burn patients for alcohol use disorders to identify those at increased risk for repeat injury and adverse effects of alcohol use. We examined associations of at-risk drinking and dependence symptoms as measured by a formal screening tool and blood alcohol concentration (BAC) to guide further screening, treatment, and research. We hypothesized that the majority of drinkers would not have symptoms of alcohol dependence, that BAC would be inadequate to screen for alcohol disorders, and that at-risk drinkers would be more likely to be unemployed and uninsured than healthy drinkers. Formal screening of English speakers, age 16 to 75, admitted to the burn service for over 24 hours was conducted for a 6-month period, using the Alcohol Use Disorders Identification Test. Of the 123 patients eligible for the study, 110 (89.4{\%}) were approached for formal screening, four refused (3.6{\%}), and 13 were missed (10.6{\%}). BAC was obtained in 68 of 110 (61.8{\%}); no patient who reported abstinence had a positive BAC. Of the 106 screened, 34.9{\%} were nondrinkers, 11.3{\%} drank daily or almost daily, and 28.3{\%} binge drank at least monthly (>4 drinks per occasion for men, >3 for women). Of the patients who drank, only eight patients reported one or more sign of dependence in the last year (11.6{\%}). For the group as a whole, 20.9{\%} met Alcohol Use Disorders Identification Test criteria for at-risk drinking, with an average BAC of 39.8 mg/dl, (range 0-242 mg/dl). Using BAC of ≥80 mg/dl, only 5.6{\%} of patients would have been identified as at-risk drinkers. Twenty-three percent of patients had no health insurance, 36{\%} of whom were at-risk drinkers compared with 17.3{\%} of insured patients (P <.05). For the group as a whole, 41.8{\%} of patients were unemployed. At-risk drinking did not differ between employed and unemployed patients (24.6{\%} vs 17.8{\%}, P >.05). Among burn patients, formal alcohol screening identified that one in five patients is at risk for further problems from their drinking and that most at-risk drinkers are binge drinkers and do not show signs of dependency. Formal screening identified more at-risk drinkers than BAC. Implications of the screening findings are 1) because most burn patients who drink are binge but not dependent drinkers, alcohol withdrawal should be infrequent, and 2) animal models of alcohol use and burn injury should study acute intoxication and binge exposure. In addition, 3) we would expect burn patients to respond to brief interventions for alcohol use disorders similar to trauma and primary care patients.",
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