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Alcohol and drug screening of adolescent trauma alert patients at a level 1 pediatric trauma center

  • Dana L. Noffsinger
    Correspondence
    Corresponding author at: 700 Children's Drive, Columbus, Ohio 43205.
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Lee Ann Wurster
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Jane Cooley
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Department of Social Work, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Lindsay Buchanan
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Department of Social Work, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Krista K. Wheeler
    Affiliations
    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Junxin Shi
    Affiliations
    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
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  • Henry Xiang
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, United States of America
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  • Jonathan I. Groner
    Affiliations
    Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America

    The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, United States of America
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Published:December 07, 2018DOI:https://doi.org/10.1016/j.ajem.2018.11.043

      Abstract

      Background

      Adolescent trauma patients are reported to have increased incidence of alcohol and other drug (AOD) use, but previous studies have included inadequate screening of the intended populations. A Level 1 Pediatric Trauma Center achieved a 94% rate of AOD screening. We hypothesized that a positive AOD screening result is associated with males, increasing age, lower socioeconomic status, violent injury mechanism, higher Injury Severity Score (ISS), lower GCS, need for operation and increased hospital length of stay.

      Methods

      After achieving high rates of screening among admitted trauma alert patients 12–17 years old, we evaluated patients presenting during 2014–2015. Chi-square tests were used to compare the percentage of patients with positive test results across sociodemographic, injury severity measures and patient outcomes.

      Results

      Three hundred and one patients met criteria for AOD screening during the study period. Ninety-four percent of these patients received screening and 18% were positive. Males (21.4%) were more often positive than females (11.6%). Increasing age was directly correlated with AOD use. Race was associated with a positive screen. Black patients more often had positive screens (40.9%), as compared with White patients (13.8%) and other races (23.5%). Patients with commercial insurance (6.6%) were less likely to be positive than those with no insurance (19.0%) or Medicaid (30.9%). Lower median household income was associated with positive AOD screening. Patients with violent injury mechanisms were more likely to screen positive (36.2%) than those with non-violent mechanisms (18.0%). No statistical differences were found with injury severity scores, the need for operation, or hospital length of stay.

      Conclusions

      With near universal screening of adolescent trauma alert admissions, positive AOD results were more often found with males, increasing age, lower socioeconomic status, and violent injury mechanism.

      Level of evidence

      Level III, Retrospective comparative study without negative criteria.

      Study Type

      Prognostic.

      Keywords

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