Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
ObjectivesAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in pat...
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| Veröffentlicht in: | BMJ open Jg. 8; H. 11; S. e024190 |
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01.11.2018
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| Abstract | ObjectivesAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.DesignRetrospective cohort study.SettingTertiary trauma centre in Halifax, Canada.Participants2306 trauma patients who required activation of the trauma team.Primary outcome measureThe primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.ResultsOverall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.ConclusionsAt this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients. |
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| AbstractList | ObjectivesAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.DesignRetrospective cohort study.SettingTertiary trauma centre in Halifax, Canada.Participants2306 trauma patients who required activation of the trauma team.Primary outcome measureThe primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.ResultsOverall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.ConclusionsAt this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients. Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing. Retrospective cohort study. Tertiary trauma centre in Halifax, Canada. 2306 trauma patients who required activation of the trauma team. The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing. Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend. At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients. Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.OBJECTIVESAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.Retrospective cohort study.DESIGNRetrospective cohort study.Tertiary trauma centre in Halifax, Canada.SETTINGTertiary trauma centre in Halifax, Canada.2306 trauma patients who required activation of the trauma team.PARTICIPANTS2306 trauma patients who required activation of the trauma team.The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.PRIMARY OUTCOME MEASUREThe primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.RESULTSOverall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients.CONCLUSIONSAt this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients. |
| Author | Karim, Saleema A Erdogan, Mete Asbridge, Mark Kureshi, Nelofar Green, Robert S Tallon, John M |
| AuthorAffiliation | 5 Department of Emergency Medicine , Vancouver General Hospital, University of British Columbia , Vancouver , British Columbia , Canada 1 Trauma Nova Scotia , NS Department of Health and Wellness , Halifax , Nova Scotia , Canada 4 Department of Health Policy and Management , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA 2 Departments of Critical Care, Emergency Medicine, and Surgery , Dalhousie University , Halifax , Nova Scotia , Canada 6 Departments of Community Health and Epidemiology and Emergency Medicine , Dalhousie University , Halifax , Nova Scotia , Canada 3 Division of Neurosurgery, Department of Surgery , Dalhousie University , Halifax , Nova Scotia , Canada |
| AuthorAffiliation_xml | – name: 5 Department of Emergency Medicine , Vancouver General Hospital, University of British Columbia , Vancouver , British Columbia , Canada – name: 3 Division of Neurosurgery, Department of Surgery , Dalhousie University , Halifax , Nova Scotia , Canada – name: 1 Trauma Nova Scotia , NS Department of Health and Wellness , Halifax , Nova Scotia , Canada – name: 2 Departments of Critical Care, Emergency Medicine, and Surgery , Dalhousie University , Halifax , Nova Scotia , Canada – name: 4 Department of Health Policy and Management , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA – name: 6 Departments of Community Health and Epidemiology and Emergency Medicine , Dalhousie University , Halifax , Nova Scotia , Canada |
| Author_xml | – sequence: 1 givenname: Mete surname: Erdogan fullname: Erdogan, Mete email: greenrs@dal.ca organization: Trauma Nova Scotia, NS Department of Health and Wellness, Halifax, Nova Scotia, Canada – sequence: 2 givenname: Nelofar surname: Kureshi fullname: Kureshi, Nelofar email: greenrs@dal.ca organization: Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada – sequence: 3 givenname: Saleema A surname: Karim fullname: Karim, Saleema A email: greenrs@dal.ca organization: Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA – sequence: 4 givenname: John M surname: Tallon fullname: Tallon, John M email: greenrs@dal.ca organization: Department of Emergency Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada – sequence: 5 givenname: Mark surname: Asbridge fullname: Asbridge, Mark email: greenrs@dal.ca organization: Departments of Community Health and Epidemiology and Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada – sequence: 6 givenname: Robert S surname: Green fullname: Green, Robert S email: greenrs@dal.ca organization: Departments of Critical Care, Emergency Medicine, and Surgery, Dalhousie University, Halifax, Nova Scotia, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30429147$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1136_emermed_2023_213186 crossref_primary_10_1016_j_alcohol_2023_11_009 crossref_primary_10_1136_emermed_2023_213419 crossref_primary_10_1111_1742_6723_13797 crossref_primary_10_1177_0003134820943555 crossref_primary_10_1111_acem_14145 |
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| SubjectTerms | Alcohol use Emergency Medicine Emergency services Epidemiology Injuries Intervention Patients Recidivism Trauma Trauma care Trauma centers Young adults |
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| Title | Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre |
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