Identification of hazardous/harmful drinking among subcritically injured patients

Acad Emerg Med. 1996 Mar;3(3):239-45. doi: 10.1111/j.1553-2712.1996.tb03427.x.

Abstract

Objectives: To examine the relationship between a saliva alcohol test (SAT) and hazardous/harmful drinking, as measured by the Alcohol Use Disorders Identification Test (AUDIT), among a sample of subcritically injured patients.

Methods: Patients (n = 78) seeking treatment for a subcritical injury were saliva-tested for alcohol and interviewed regarding their drinking behaviors and related difficulties. Associations of SAT values with AUDIT results were determined.

Results: SAT results and hazardous/harmful drinking were not independent events (p < 0.001). Estimates of sensitivity and specificity (using a dichotomous SAT result [> or = 4 mmol/L] to identify positive AUDIT patients) were 65.2% and 83.6%, respectively. SAT-positive people had significantly higher AUDIT scores than did SAT-negative individuals (p < 0.0001). Patients experiencing assault-type injuries were much more likely to be SAT-positive than were patients incurring other types of injury. Discriminant function analysis suggests that AUDIT scores can successfully identify SAT-positive and SAT-negative patients; the analysis accounted for 42.5% of the variance and correctly classified 84.6% of the sample.

Conclusions: The use of an easy-to-administer, noninvasive, routine SAT, among patients presenting for a subcritical injury in a hospital ED, provides a mechanism for the identification of individuals with a history of hazardous/harmful drinking. However, since discrimination of hazardous/harmful drinking is imperfect, some caution is warranted when conducting such screening activities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accident Proneness
  • Adolescent
  • Adult
  • Aged
  • Alcoholic Intoxication / blood
  • Alcoholic Intoxication / complications*
  • Alcoholic Intoxication / diagnosis
  • Analysis of Variance
  • Emergency Service, Hospital
  • Ethanol / analysis*
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Saliva / chemistry*
  • Sensitivity and Specificity
  • Wounds and Injuries / blood
  • Wounds and Injuries / complications*

Substances

  • Ethanol