58 CAGE Substance use Scores and Trajectories Over Time Following Burn Injury: A Burn Model System National Database Study

Abstract Introduction The self-reported CAGE substance use tool (Cut down, Annoyed, Guilty, and Eye-opener) screens for potential problems with alcohol or drug use. This study aims to examine the prevalence of substance use in the Burn Model System (BMS) National Database adult population by reviewing CAGE substance use scores and trajectories over time following burn injury. Methods Individuals 18 years of age or older, alive at discharge (DC), and with 2 complete self-reported CAGE questionnaires (at DC and at least one follow-up time point at 6, 12, or 24 months post-injury) were included. Enrollment criteria includes individuals with ≥ 10% Total Body Surface Area (TBSA) burned (age ≥ 65 years) or 20% TBSA burned (age 18–64 years) and/or burns to critical areas. CAGE questions at DC assessed a patient’s history of alcohol or drug use in the last 12 months. Demographic and clinical characteristics of those who reported positive CAGE scores (total score of ≥ 2) and those who reported negative CAGE scores (total score of 0 or 1) for either alcohol or drug use were compared. Changes in CAGE scores between discharge and follow-up were also analyzed using paired t-tests. Results A total of 408 adult burn survivors were included in the analysis. Individuals reporting positive CAGE scores for either alcohol or drug use at DC were 70% male with a mean age of 42.9 years (SD=16.4, range=18.5) and mean burn size of 21% TBSA burned. Individuals reporting negative CAGE scores at DC were 83% male with a mean age of 47.6 years (SD=13.8, range=18.7) and mean burn size of 19% TBSA burned. Statistically significant differences in age and gender were found (p < 0.01). TBSA burned did not differ significantly between the two populations. Approximately 1 out of 5 people reported a positive CAGE score (18%) at time of DC and about half of those (47%) reported positive CAGE scores at follow-up. Of those who reported negative CAGE scores at DC, 10% reported a positive CAGE score at follow-up. Conclusions Substance use at DC and follow-up in this sample is potentially an important concern. These CAGE scores reflect the need for health care providers to counsel patients about substance use and the need to screen burn survivors for substance use at later follow-ups. Applicability of Research to Practice Further investigation is needed to understand the extent of substance use in the burn survivor population. Increased efforts for more effective substance use treatment appropriate