Validity of self-reports of drinking before injury by cause of injury and societal context among emergency department patients.

INTRODUCTION AND AIMS: Validity of self-reported alcohol consumption is a topic of continued interest with mixed findings. Validity of self-reports prior to injury is analysed among emergency department (ED) patients by cause of injury, blood alcohol concentration (BAC) and societal context.

DESIGN AND

METHODS

Data are on 16 196 injured patients from 23 countries in the International Collaborative Alcohol and Injury Project. The proportion of those reporting drinking within 6 h prior to injury among the 2658 BAC positive patients was analysed by injury cause (traffic, violence, falls, other), BAC level (0.01-0.079 mg%, ≥ 0.08 mg%), detrimental drinking pattern (DDP) and the International Alcohol Policy and Injury Index (IAPII).

RESULTS

Validity averaged 92%, ranging from 85% for drivers to 95% for violence-related injuries. Validity was significantly lower at lower BAC levels for all injuries (P < 0.01) and for violence and falls. Countries with a high DDP and those with lower IAPII scores (less restrictive alcohol policy) also appeared more likely to deny drinking which was significant for DDP for falls (P < 0.01) and for IAPII for passengers/pedestrians (P < 0.05) and violence (P < 0.05). Validity was highest for high IAPII countries, ranging from 92% to 99%.

DISCUSSION AND

CONCLUSIONS

Validity of self-report compared to breathalyzer readings at the time of admission to the ED was high, but varied by cause of injury, BAC level, country-level detrimental drinking patterns and the restrictiveness of alcohol control policy. Findings may support the utility or self-reports as an alternative to a quantifiable measure of BAC in the ED setting.