Identifying excessive chronic alcohol use with phosphatidylethanol in patients with suspected severe injury-results from the IDART study

Introduction: Acute and chronic alcohol use are well-known risk factors for accidents and injuries, and concurrent psychoactive druguse can increase injury risk further. Phosphatidylethanol (PEth) 16:0/18:1 is a biomarker used to determine alcohol consumption theprevious 3-4 weeks. The aim was to investigate the prevalence of chronic alcohol use in trauma patients, as determined by PEth16:0/18:1 concentrations, and how excessive chronic alcohol use relate to demographic variables, injury mechanisms and drug use. Setting: Patients received at Norwegian trauma hospitals from March 2019 to February 2020. The study is part of the Impairing Drugsand Alcohol as Risk factors for Traumatic Injuries study. Methods: All patients aged >= 16 years received with trauma team were included in the study. Data on injury date and mechanism,gender and age was registered. Blood samples were analyzed for 22 psychoactive medicinal and illicit drugs, ethanol and phos-phatidylethanol 16:0/18:1. Regression analyses were conducted to assess associations between alcohol use and gender, age, injurymechanism and drug use. Results and Conclusion: Of the 4845 patients included in the study, 10% had PEth 16:0/18:1 concentration >= 600 nM (similar to 430 ng/mL),indicative of excessive chronic alcohol use. Being male, between 44-61 years old, involved in violence, and testing positive for medicinaldrugs was associated with excessive chronic alcohol use.Excessive chronic alcohol use was common among males, middle-aged, patients with violence as injury mechanism and those withmedicinal drug use. These findings emphasize the need to detect and treat excessive chronic alcohol use among trauma patients.