Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

PLoS One. 2017 Aug 16;12(8):e0182441. doi: 10.1371/journal.pone.0182441. eCollection 2017.

Abstract

Objective: Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.

Methods: Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used.

Results: We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41-0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.

Conclusion: The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

MeSH terms

  • Adult
  • Alcohol Drinking*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Illicit Drugs*
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Spain / epidemiology
  • Trauma Centers
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / etiology*

Substances

  • Illicit Drugs

Grant support

This work was supported by the Dirección General de Tráfico, Spain [grant number: 0100DGT22389] http://www.dgt.es/ (EFM); and the Consejería de Salud, Junta de Andalucía, Spain [grant number: PI-0691-2013] http://www.juntadeandalucia.es/salud/sites/csalud/portal/index.jsp (RVL). JFN is funded by an individual research grant from the Spanish Ministry of Education, Culture and Sport (FPU13/00669) http://www.mecd.gob.es/portada-mecd/. The study sponsors had no role in the design of the study; the collection, analysis, or interpretation of data; the writing of the report; or the decision to submit the article for publication.