Screening for alcohol and substance use in pediatric trauma patients: A retrospective review.

PURPOSE: Alcohol and drug use in adolescence is associated with traumatic injuries. This study aimed to assess the rates of screening for substance use in pediatric trauma patients presenting at a single Canadian center.

METHODS

A retrospective chart review of pediatric trauma patients (aged 12-17) was performed. Injury specifics, rates of patients screened for alcohol and/or substance use, and screening outcomes were determined. Patients screened were compared to those not screened. Continuous variables were analyzed using independent samples t-tests and categorical using chi-square. Significance was set at p < 0.05.

RESULTS

Three hundred twenty-seven patients were included, with 217(66%) being male. The average age was 14.6 years (±1.5). Traffic collisions accounted for 50% of injuries. A blood alcohol test was conducted for significantly more patients (199, 61%) than a urine drug screen (55, 17%; p < 0.001). Of those screened, 27/199(14%) tested positive for alcohol and 29/55(53%) for drugs. Older age and increased injury severity were associated with being screened for drugs (p = 0.000, p = 0.050). Only 39% of patients with positive screening tests were referred on to secondary services such as inpatient psychiatry or social work.

CONCLUSION

Screening rates remain low. Institutional guidelines for alcohol and drug screening in trauma patients should be instituted to avoid random screening and underestimations of substance involvement.

TYPE OF STUDY: Retrospective Chart Review.

LEVEL OF EVIDENCE: III.