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Dunn C, Zatzick D, Russo J, Rivara FP, Roy-Byrne P, Ries R, Wisner D, Gentilello L. J. Trauma 2003; 54(4): 707-712.


Department of Psychiatry, University of Washington School of Medicine, Seattle, USA.


(Copyright © 2003, Lippincott Williams and Wilkins)






BACKGROUND: To improve reinjury prevention strategies targeting hazardous drinking, we determined its predictors and longitudinal course in the year after injury. METHODS: This was a prospective study of 101 randomly selected hospitalized trauma patients who before injury represented the full range of substance abuse, from severe to none. We hypothesized that clinical data obtained routinely by trauma centers would predict hazardous drinking during the postinjury year. RESULTS: Drug and alcohol use dropped markedly 1 month after injury but returned to preinjury levels by 4 months. Forty-one percent of the sample drank hazardously before injury, and 55% drank hazardously after. From before to after injury, 20% of patients worsened their hazardous drinking status, and only 6% of patients improved it. Three clinical predictors of hazardous drinking during the year were identified: any positive blood alcohol concentration > 0 at admission (odds ratio [OR], 9.18; 95% confidence interval [CI], 2.51-33.56), any days > 0 of using nonprescription drugs of abuse in the month before injury (OR, 6.63; 95% CI, 1.76-25.04), and suffering an intentional injury (OR, 5.1; 95% CI, 1.38-18.77). CONCLUSION: Efforts to reduce hazardous drinking after injury should target patients with this risk profile and focus on the 1- to 4-month period after injury hospitalization.


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