Highlights from AAST - SBIRT does work

This study shows that applying SBIRT to at risk patients may reduce future trauma admissions in those patients.

SCREENING, BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) REDUCES ALCOHOL RELATED TRAUMA READMISSIONS John Gillespie, MD, Mark D. Cipolle*, M.D., Ph.D., Joan Pirrung, APRN, BC, Karen Cratz, LCSW, Paula Veneri, RN, MBA, Glen Tinkoff*, M.D., Christianacare Health Services Invited Discussant: Michael J. Sise Introduction: Excessive alcohol consumption is the third leading preventable cause of death in the United States and is associated with multiple adverse health consequences, unintentional injuries, and violence. We started a SBIRT program with a full-time counselor in 2008. This study was performed to test the hypothesis that institution of the SBIRT program would reduce alcohol related trauma readmissions at our trauma center. Methods: This study was approved by our IRB and was conducted from the inception of our SBIRT program, February 2008, until August 2011. SBIRT referrals were obtained on all patients with a positive blood alcohol concentration (BAC) on admission or by referral from any clinician caring for the patient regardless of admission BAC status. To check for trauma recidivism, we compared readmission rates to the trauma service for all patients who had participated in our SBIRT program to an immediate historic trauma registry control group (April 2006 to March 2008) admitted with a BAC ≥0.08 prior to the initiation of the SBIRT program. Chi Square was used to test for differences between groups. Results: From February 2008 to August 2011, 12,635 patients were admitted to the trauma service with 1,273 patients being referred to the SBIRT counselor. In patients initially admitted with a BAC≥0.08, trauma readmission rates, regardless of readmission blood alcohol status, tended to be lower in patients that underwent SBIRT compared to the pre-SBIRT cohort, 2.35% (30/1237) vs. 3.54% (39/1103) (p=0.1). However, there were significantly less SBIRT patients readmitted with a positive BAC compared to the pre-SBIRT cohort, 0.63% (8/1273) vs. 1.45% (16/1103) (p=0.046). Conclusion: These results suggest that institution of the SBIRT program has resulted in a greater than 50% reduction in alcohol related trauma readmissions at our trauma center.