Emergency department alcohol screening in Illinois pediatric trauma patients, 1999-2009

Introduction Although adult trauma patients are routinely screened for alcohol and other drugs, pediatric patients are tested less consistently, even though many who are screened do test positive. Our goal is to characterize the pediatric trauma patients who are tested for alcohol and drugs and those who test positive in a comprehensive statewide trauma system. Methods The Illinois State Trauma Registry from 1999-2009 was queried for all patients under age 19 who presented with an injury severity score above 10. Any blood alcohol above zero was considered positive, while marijuana and cocaine testing were used for drug results. Using R statistical software, we examined the relationship of testing to patient age, gender, race, injury mechanism, and systolic BP, by multivariate logistic regression. A similar regression was performed on screening results. Results Of 12,264 patients ages 1-18, 40% were tested for alcohol (23% positive) and 37% for drugs (21% positive). Black and Hispanic patients were screened for alcohol most frequently, but Hispanics were most likely to test positive (30%). Age strongly predicted positive drug and alcohol tests, but up to 7% of children under 12 screened positive. Male patients were more likely to screen positive for both alcohol and drugs. Conclusions Unsurprisingly, the data show that older patients more commonly use alcohol and drugs, and they are tested more frequently. Our findings demonstrate racial and gender disparities in testing, possibly revealing racial or socioeconomic biases. Universal testing may help diagnose and treat unrecognized substance use issues.