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Association Between Injury Severity and Readiness to Change in Alcohol Related Trauma

Abstract

Out of approximately 800,000 traumas annually in the US, close to half have been deemed to be alcohol related. Despite our best efforts, over 90% of trauma deaths are deemed non preventable with current medical interventions. As we shift focus to averting alcohol related traumas, understanding the factors influencing patient's Readiness to Change (RTC) is of utmost importance for successful interventions. Severity of an alcohol related incident and traumatic injury have been linked with an increase in patient's Readiness to undergo changes in their alcohol behavior, which in turn resulted in improved alcohol behavior in follow up. Conducted at UCI Medical Center, our study explored injury severity's influence on patient's RTC which was measured on a 10-point Likert scale; injury severity was determined by the Injury Severity Score (ISS). Utilizing the UCI designed Computerized Alcohol Screening and brief Intervention (CASI) module, we found that, despite appropriate sample size, the ISS was not significantly associated with trauma patients' RTC or commitment to change. Further analysis of BAC as a potential RTC modifying factor showed that BAC positive trauma patients were almost twice as likely to be ready for change as compared to BAC negative patients after controlling for baseline characteristics including ISS and alcohol abuse/dependence risk. The results suggest that the dual effects of trauma with alcohol involvement may be more important to trauma patients than the severity of their injuries and their baseline alcohol risk in being ready for a change in their alcohol behavior.

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