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Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre

OBJECTIVES: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in p...

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Autores principales: Erdogan, Mete, Kureshi, Nelofar, Karim, Saleema A, Tallon, John M, Asbridge, Mark, Green, Robert S
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252682/
https://www.ncbi.nlm.nih.gov/pubmed/30429147
http://dx.doi.org/10.1136/bmjopen-2018-024190
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author Erdogan, Mete
Kureshi, Nelofar
Karim, Saleema A
Tallon, John M
Asbridge, Mark
Green, Robert S
author_facet Erdogan, Mete
Kureshi, Nelofar
Karim, Saleema A
Tallon, John M
Asbridge, Mark
Green, Robert S
author_sort Erdogan, Mete
collection PubMed
description OBJECTIVES: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing. DESIGN: Retrospective cohort study. SETTING: Tertiary trauma centre in Halifax, Canada. PARTICIPANTS: 2306 trauma patients who required activation of the trauma team. PRIMARY OUTCOME MEASURE: The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing. RESULTS: Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend. CONCLUSIONS: At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients.
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spelling pubmed-62526822018-12-11 Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre Erdogan, Mete Kureshi, Nelofar Karim, Saleema A Tallon, John M Asbridge, Mark Green, Robert S BMJ Open Emergency Medicine OBJECTIVES: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing. DESIGN: Retrospective cohort study. SETTING: Tertiary trauma centre in Halifax, Canada. PARTICIPANTS: 2306 trauma patients who required activation of the trauma team. PRIMARY OUTCOME MEASURE: The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing. RESULTS: Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend. CONCLUSIONS: At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients. BMJ Publishing Group 2018-11-13 /pmc/articles/PMC6252682/ /pubmed/30429147 http://dx.doi.org/10.1136/bmjopen-2018-024190 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Emergency Medicine
Erdogan, Mete
Kureshi, Nelofar
Karim, Saleema A
Tallon, John M
Asbridge, Mark
Green, Robert S
Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title_full Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title_fullStr Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title_full_unstemmed Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title_short Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
title_sort retrospective analysis of alcohol testing in trauma team activation patients at a canadian tertiary trauma centre
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252682/
https://www.ncbi.nlm.nih.gov/pubmed/30429147
http://dx.doi.org/10.1136/bmjopen-2018-024190
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