Screening Adolescent Trauma Patients for Substance Use at 10 Pediatric Trauma Centers.
Screening Adolescent Trauma Patients for Substance Use at 10 Pediatric Trauma Centers.
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DOI：
10.1097/jtn.0000000000000537
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Baird J
中科院分区：
文献类型：
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作者：
Mello MJ;Becker SJ;Spirito A;Bromberg JR;Wills H;Barczyk A;Lee L;Pruitt C;Ebel BE;Zonfrillo MR;Nimaja E;Scott K;Kiragu A;Nasr IW;Aidlen JT;Maxson RT;Baird J
美国外科医生学会创伤委员会建议将普遍的酒精筛查作为入院创伤患者评估的一部分。然而，据报道，入院的成人和青少年创伤患者的筛查率不理想。缺乏筛查反过来又限制了创伤服务机构在患者入院期间为患者提供简短干预以及出院后转诊治疗的能力。本研究的主要目的是调查全国 10 个儿科创伤中心入院受伤青少年当前的酒精和其他药物筛查率。这项回顾性观察性研究嵌套在更大规模的青少年筛查、简短干预和转介至治疗实施研究 (Clinicaltrials.gov NCT03297060) 中。十个儿科创伤中心参与了对 2018 年 3 月 1 日至 2018 年 11 月 30 日期间就诊的青少年创伤患者随机样本的回顾性图表审查。在 10 个参与的创伤中心中提取了 300 张图表（每个中心 n = 30）。在 30 个提取的图表中，不同中心的筛查率差异很大，从 5 个（16.7%）到 28 个（93.3%）不等。最常见的筛查类型是血液酒精浓度 (BAC)（N = 80，占所有筛查的 35.2%），其次是 CRAFFT（N = 79，26.3%），然后是尿液药物筛查 (UDS)（N = 77，25.6%）。 BAC 测试发现 11 名患者近期饮酒呈阳性。 CRAFFT 确定了 11 名阳性患者。对于进入儿科创伤中心的青少年来说，酒精和药物筛查并未得到充分利用。需要更多的研究来了解如何最好地利用儿科创伤就诊的教学时刻，以确保对青少年酒精或其他药物 (AOD) 使用进行全面筛查。
The American College of Surgeons Committee on Trauma recommends universal alcohol screening be part of the evaluation of admitted trauma patients. Yet, suboptimal screening rates have been reported for admitted adult and adolescent trauma patients. This lack of screening, in turn, has limited the ability of trauma services to provide patients with brief interventions during their hospital admission and subsequent referrals to treatment after discharge. The primary aim of this study was to examine current rates of alcohol and other drug screening with admitted injured adolescents across a national cohort of 10 pediatric trauma centers. This retrospective observational study was nested within a larger adolescent screening, brief intervention, and referral to treatment implementation study (Clinicaltrials.gov NCT03297060). Ten pediatric trauma centers participated in a retrospective chart review of a random sample of adolescent trauma patients presenting for care between March 1, 2018, and November 30, 2018. Three hundred charts were abstracted across the 10 participating trauma centers (n = 30 per site). Screening rates varied substantially across centers from five (16.7%) to 28 (93.3%) of the 30 extracted charts. The most frequent screening type documented was blood alcohol concentration (BAC) (N = 80, 35.2% of all screens), followed by the CRAFFT (N = 79, 26.3%), and then the urine drug screen (UDS) (N = 77, 25.6%). The BAC test identified 11 patients as positive for recent alcohol use. The CRAFFT identified 11 positive patients. Alcohol and drug screening is underutilized for adolescents admitted to pediatric trauma centers. More research is warranted on how best to utilize the teachable moment of the pediatric trauma visit to ensure comprehensive screening of adolescent alcohol or other drug (AOD) use.