Online Program

Emergency department alcohol screening in Illinois pediatric trauma patients, 1999-2009

Monday, November 4, 2013

Norman Nicolson, BA, School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
Patrick Lank, MD, Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
Marie Crandall, MD, MPH, FACS, Department of Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL
Introduction Although adult trauma patients are routinely screened for alcohol and other drugs, pediatric patients are tested less consistently, even though many who are screened do test positive. Our goal is to characterize the pediatric trauma patients who are tested for alcohol and drugs and those who test positive in a comprehensive statewide trauma system. Methods The Illinois State Trauma Registry from 1999-2009 was queried for all patients under age 19 who presented with an injury severity score above 10. Any blood alcohol above zero was considered positive, while marijuana and cocaine testing were used for drug results. Using R statistical software, we examined the relationship of testing to patient age, gender, race, injury mechanism, and systolic BP, by multivariate logistic regression. A similar regression was performed on screening results. Results Of 12,264 patients ages 1-18, 40% were tested for alcohol (23% positive) and 37% for drugs (21% positive). Black and Hispanic patients were screened for alcohol most frequently, but Hispanics were most likely to test positive (30%). Age strongly predicted positive drug and alcohol tests, but up to 7% of children under 12 screened positive. Male patients were more likely to screen positive for both alcohol and drugs. Conclusions Unsurprisingly, the data show that older patients more commonly use alcohol and drugs, and they are tested more frequently. Our findings demonstrate racial and gender disparities in testing, possibly revealing racial or socioeconomic biases. Universal testing may help diagnose and treat unrecognized substance use issues.

Learning Areas:

Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify disparities in drug and alcohol testing of pediatric trauma patients to help inform better health practices.

Keyword(s): Adolescent Health, Data/Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived of this study, performed the analysis, and wrote successive drafts of the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.