Citation

Kodadek LM, Freeman JJ, Tiwary D, Drake MD, Schroeder ME, Dultz L, White C, Aziz HA, Crandall M, Como JJ, Rattan R. J. Trauma Acute Care Surg. 2019; ePub(ePub): ePub.

Affiliation

Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN General Surgery, Trauma, and Surgical Critical Care, Texas Health Harris Hospital, Fort Worth, TX Central Florida Regional Hospital, Sanford, FL Trauma and Surgical Critical Care, Brody School of Medicine at East Carolina University, Greenville, NC Department of Surgery, Rutgers-Robert Wood Johnson University Hospital Division of General and Acute Care Surgery, University of Texas Southwestern Parkland Hospital, Dallas, TX Department of Surgery, Trauma and Critical Care, Medical College of Georgia at Augusta University, Augusta, GA Department of Surgery, Hamad General Hospital, Doha, Qatar University of Florida College of Medicine, Jacksonville, Florida Department of Surgery, MetroHealth Medical Center, Cleveland, OH Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000002501

PMID

31490336

Abstract

BACKGROUND: Unaddressed alcohol use among injured patients may result in recurrent injury or death. Many trauma centers incorporate alcohol screening, brief intervention, and referral to treatment for injured patients with alcohol use disorders, but systematic reviews evaluating the impact of these interventions are lacking.

METHODS: An evidence-based systematic review was performed to answer the following population, intervention, comparator, outcomes (PICO) question: Among adult patients presenting for acute injury, should emergency department (ED), trauma center, or hospital-based alcohol screening with brief intervention and/or referral to treatment be instituted compared with usual care to prevent or decrease reinjury, hospital readmission, alcohol-related offenses, and/or alcohol consumption? A librarian-initiated query of PubMed, MEDLINE, and the Cochrane Library was performed. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to assess the quality of the evidence and create recommendations. The study was registered with PROSPERO (Registration number CRD42019122333).

RESULTS: Eleven studies met criteria for inclusion, with a total of 1,897 patients who underwent hospital-based alcohol screening, brief intervention, and/or referral to treatment for appropriate patients. There was a relative paucity of data, and studies varied considerably in terms of design, interventions, and outcomes of interest. Overall evidence was assessed as low quality, but a large effect size of intervention was present.

CONCLUSIONS: In adult trauma patients, we conditionally recommend ED, trauma center, or hospital-based alcohol screening with brief intervention and referral to treatment for appropriate patients in order to reduce alcohol-related reinjury. TYPE OF STUDY: Systematic review LEVEL OF EVIDENCE: Level III evidence.

Language: en