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Analysis of Alcohol and Drug Screening Results in Adolescent Trauma Alerts at a Level 1 Pediatric Trauma Center
Dana L. Noffsinger, CPNP-AC1,2, LeeAnn Wurster, RN, MS, CPNP1,2, Krista Wheeler, MD2,3, Junxin Shi, MD, PhD2,3, Huiyun Xiang, MD, MPH, Ph2,3,4, Jonathan I. Groner, MD, FAAP1,2,3,4. 1Trauma Program, Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA, 2Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA, 3Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA, 4The Ohio State University College of Medicine, Columbus, OH, USA.

Background: Alcohol and other drug(AOD) screening has been recommended for adolescent trauma patients age 12 years and older. Previous studies in this population have demonstrated inadequate screening adherence. By improving alcohol and drug screening rates, analysis of results more closely depicts actual use and its impact on patient outcomes.

Methods: A Level 1 Pediatric Trauma Center increased its AOD screening rate to 95% by implementing a quality improvement initiative. After receiving IRB approval, we performed a trauma database query and chart review of patients aged 12-17 years presenting as a trauma alert and admitted from 2014-2015.

Results: Three hundred and one patients met criteria for AOD screening. Ninety-five percent of patients received AOD screening and twenty-one percent were found to be positive. Males(23.4%) were more likely to be positive than females(15.7%). Age was directly correlated with AOD use: 12-13 years(9.8%), 14-15 years(22.8%) and 16-17 years(36.8%). Black race(41.8%) was associated with a positive screen when compared to white race(17.2%). Healthcare payment source, used as a marker for economic status, showed that patients with commercial insurance(11.8%) were less likely than those with no insurance(20.0%) or Medicaid(31.3%) to be positive. Violent injury mechanism(n=50, 36.2%) was more likely to screen positive than non-violent mechanism(n=251, 18.0%). No statistical significance was found regarding ISS score, GCS, need for operation, or length of stay.

Conclusions: Increased AOD use was found in males, black race, increasing age, violent injury mechanism and lower economic status. Data may be used to guide prevention strategies.

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