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Role of Alcohol in Trauma Recidivism

​Trauma recidivists are patients who present to a hospital or trauma centre on more than one occasion for different incidents of traumatic injury. Prior studies have associated traumatic injury with risk-taking behaviours such as the use of weapons, fighting, criminal behaviour, and abuse of drugs or alcohol. With advances in trauma patient care, many patients recover from their injuries; however, some patients continue risk taking behaviours, or seek out coping mechanisms such as use of alcohol or drugs in order to deal with the disability associated with their initial trauma. Thus, a proportion of the trauma population may have or develop a predisposition to trauma.

We searched 4 electronic databases (MEDLINE, Embase, CINAHL, Web of Science) for all articles that might provide evidence on the proportion of trauma recidivism related to use of alcohol. After removal of duplicates, the search strategy yielded 2470 records for screening. Only primary studies that reported on repeated admissions to a hospital or trauma center for traumatic injuries specifically related to alcohol use were included. Descriptive statistics were used to assess study characteristics and the prevalence of trauma recidivism related to alcohol use. Details of the study are shown in the infographic.

A total of 12 studies met all inclusion criteria. Studies were published between 1989 and 2014. Overall, there were 3386 trauma recidivists among included studies. The proportion of trauma recidivists with evidence of alcohol use on admission ranged from 26.7% to 76.9% (median 46.4%). The aggregated sample produced a weighted estimate of 41.0% (1388/3386) for alcohol-related trauma recidivism. In four studies, the association between alcohol and trauma recidivism was examined; all four found a positive association between alcohol use and repeated admission for traumatic injury. Studies varied considerably in design, trauma populations, periods for evaluating recidivism, definitions for positive alcohol on admission, and methods used to determine alcohol use.

Evidence from current literature suggests that 41.0% of trauma recidivism is related to use of alcohol. Due to methodological limitations among the studies included for review, this may underestimate the actual prevalence of alcohol-related trauma recidivism.

This study was published in the March issue of Injury.

Posted July 6, 2016

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