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Alcohol-related trauma reinjury prevention with hospital-based screening in adult populations: An Eastern Association for the Surgery of Trauma evidence-based systematic review. J Trauma Acute Care Surg 2020 01;88(1):106-112

Date

09/07/2019

Pubmed ID

31490336

DOI

10.1097/TA.0000000000002501

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 question: Among adult patients presenting for acute injury, should emergency department, 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 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.

CONCLUSION: In adult trauma patients, we conditionally recommend emergency department, trauma center, or hospital-based alcohol screening with brief intervention and referral to treatment for appropriate patients in order to reduce alcohol-related reinjury.

LEVEL OF EVIDENCE: Systematic review, Level III.

Author List

Kodadek LM, Freeman JJ, Tiwary D, Drake MD, Schroeder ME, Dultz L, White C, Abdel Aziz H, Crandall M, Como JJ, Rattan R

Author

Mary Elizabeth Schroeder MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Alcohol Drinking
Emergency Service, Hospital
Evidence-Based Medicine
General Surgery
Humans
Incidence
Mass Screening
Patient Readmission
Practice Guidelines as Topic
Referral and Consultation
Secondary Prevention
Societies, Medical
Trauma Centers
United States
Wounds and Injuries
jenkins-FCD Prod-469 c3fc8ab87196149f9b23743c01b947d47e7319e5