Admission to Intensive Care for a Trauma Related to Alcohol or Drugs, a 'Teachable Moment' for the Beginning of a Change

Enferm Intensiva. Jan-Mar 2017;28(1):4-12. doi: 10.1016/j.enfi.2016.12.002. Epub 2017 Jan 24.
[Article in English, Spanish]

Abstract

Objectives: To estimate how many of the trauma patients admitted to ICU would be candidates for a secondary prevention programme for trauma related to alcohol or drug use by brief motivational intervention and to define what factors prevent that intervention being performed.

Methods: All 16-70year old trauma patients (n=242) admitted to ICU in 32 non-consecutive months (November 2011 to March 2015) were included in the study, coinciding with the implementation of a screening and brief motivational intervention programme for trauma patients related to substance consumption. The programme includes screening for exposure to substances at admission. Sociodemographic and clinical variables were collected prospectively.

Results: The screening for substances was not performed in 38 (15.7%) of all admitted patients. Of the patients screened, 101 (49.5%) were negative. The variables that in greater proportion impeded intervention between screening positive patients were neurological damage due to the trauma with 23 patients (37.1%) and prior psychiatric disorder with 18 (29%). Both variables were associated with substance consumption: negatives 9.9% vs positive 22.3% (P=.001) and negatives 3% vs positive 17.5% (P=.016) respectively. The number of candidates for motivational intervention was 41, 16.9% of all admitted patients.

Conclusions: Almost 2 out of 10 patients were potential candidates. The factors that in a greater proportion precluded the intervention were the same as those associated with consumption. Mortality in ICU was associated with non-compliance with the screening protocol.

Keywords: Accident prevention; Alcohol; Drogas ilícitas; Entrevista motivacional; Illicit drugs; Motivational interview; Prevención de accidentes; Psicofármacos; Psychotropic drugs; Traumatic injuries; Traumatismos.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Alcoholism / prevention & control
  • Attitude to Health
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Patient Admission*
  • Prospective Studies
  • Secondary Prevention*
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / prevention & control*
  • Substance-Related Disorders / psychology
  • Wounds and Injuries / etiology*
  • Wounds and Injuries / prevention & control*
  • Wounds and Injuries / psychology
  • Young Adult