Identification and characterization of older emergency department patients with high-risk alcohol use.
Identification and characterization of older emergency department patients with high-risk alcohol use.
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DOI：
10.1002/emp2.12196
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发表时间：
2020-10
影响因子：
2.3
通讯作者：
D'Onofrio G
中科院分区：
文献类型：
--
作者：
Shenvi CL;Weaver MA;Biese KJ;Wang Y;Revankar R;Fatade Y;Aylward A;Busby-Whitehead J;Platts-Mills TF;D'Onofrio G
老年人使用高风险酒精是一个常见但未被认识到的问题。我们测试了一种简单的筛查工具来识别高危人群。这是一项在单一急诊科进行的前瞻性横断面研究。国家酒精滥用和酒精中毒研究所（NIAAA）将高危酒精使用定义为每周饮酒>7次或每次饮酒>3次。我们使用时间轴随访（TLFB）方法作为参考标准和基于NIAAA指南的新的2问题筛选器，评估了≥ 65岁患者的酒精使用情况。使用酒精使用障碍识别测试（AUDIT）和削减，烦恼，内疚，大开眼界（CAGE）屏幕进行比较。我们从高风险和低风险饮酒者的方便样本中收集了人口统计信息。我们筛选了2250名老年人，其中180名（8%）符合高风险使用标准。入组了98名高风险和124名低风险个体。使用TLFB作为参考，2问题筛选器的灵敏度为98%（95% CI，93%-100%），特异性为87%（95% CI，80%-92%）。它比AUDIT或CAGE工具具有更高的灵敏度。高危组主要为男性（65% vs 35%，P < 0.001）。从65岁到92岁，他们每周平均喝14杯酒。他们有较高的药物使用治疗（17%比2%，P < 0.001）和目前的烟草使用（24%比9%，P = 0.004）。一个快速的，2个问题的筛选器可以识别高风险饮酒者，其灵敏度高于AUDIT或CAGE筛查。它可以与更具体的问卷一起使用，以指导治疗。
High‐risk alcohol use in the elderly is a common but underrecognized problem. We tested a brief screening instrument to identify high‐risk individuals. This was a prospective, cross‐sectional study conducted at a single emergency department. High‐risk alcohol use was defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines as >7 drinks/week or >3 drinks/occasion. We assessed alcohol use in patients aged ≥ 65 years using the timeline follow back (TLFB) method as a reference standard and a new, 2‐question screener based on NIAAA guidelines. The Alcohol Use Disorders Identification Test (AUDIT) and Cut down, Annoyed, Guilty, Eye‐opener (CAGE) screens were used for comparison. We collected demographic information from a convenience sample of high‐ and low‐risk drinkers. We screened 2250 older adults and 180 (8%) met criteria for high‐risk use. Ninety‐eight high‐risk and 124 low‐risk individuals were enrolled. The 2‐question screener had sensitivity of 98% (95% CI, 93%–100%) and specificity of 87% (95% CI, 80%–92%) using TLFB as the reference. It had higher sensitivity than the AUDIT or CAGE tools. The high‐risk group was predominantly male (65% vs 35%, P < 0.001). They drank a median of 14 drinks per week across all ages from 65 to 92. They had higher rates of prior substance use treatment (17% vs 2%, P < 0.001) and current tobacco use (24% vs 9%, P = 0.004). A rapid, 2‐question screener can identify high‐risk drinkers with higher sensitivity than AUDIT or CAGE screening. It could be used in concert with more specific questionnaires to guide treatment.
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影响因子：
9
作者：
Gentilello, LM;Rivara, FP;Ries, RR
通讯作者：
Ries, RR
DOI：
10.1111/j.1532-5415.2007.01103.x
发表时间：
2007-04-01
影响因子：
6.3
作者：
Li, Chunyu;Friedman, Bruce;Fiscella, Kevin
通讯作者：
Fiscella, Kevin
影响因子：
5
作者：
MALMIVAARA, A;HELIOVAARA, M;AROMAA, A
通讯作者：
AROMAA, A
影响因子：
6.3
作者：
McEvoy, Linda K.;Kritz-Silverstein, Donna;Laughlin, Gail A.
通讯作者：
Laughlin, Gail A.
影响因子：
25.8
作者：
Grant, Bridget F.;Chou, S. Patricia;Hasin, Deborah S.
通讯作者：
Hasin, Deborah S.