Alcohol Screening Scores Predict Fracture Risk
The Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) is a three-item screen that can be routinely administered to primary care patients and has been widely adopted for alcohol screening. Research is needed to determine whether it might be valid for purposes other than screening, such as predicting alcohol-related health problems; for example, alcohol consumption has been linked to subsequent osteoporotic and other bone fractures in many studies. This study examined the association between AUDIT-C scores and the risk for fractures among Veterans who received care at seven VA primary care clinics across the country. From the Ambulatory Care Quality Improvement Project (ACQUIP) trial (conducted 1997-1999), 32,622 Veterans completed the AUDIT-C as part of a health survey and were included in the present study.
Findings show that after adjusting for comorbidities and demographics, having an AUDIT-C score of 10 or greater was associated with doubling the risk of an osteoporotic fracture compared to AUDIT-C scores of 1 to 3, while an AUDIT-C of 6 or greater was associated with about a 1.5-fold increase in the risk of a fracture that was not typical of osteoporosis. This suggests that alcohol screening scores could help clinicians quickly assess and provide feedback to patients on their alcohol-related fracture risks, much the way other screening tests (e.g. blood pressure or lipids) are used.
Harris A, Bryson C, Sun H, Blough D, and Bradley K. Alcohol Screening Scores Predict Risk of Subsequent Fractures. Substance Use and Misuse July 2009;44(8):1055-69.
This study was funded by HSR&D. Dr. Harris is part of HSR&D’s Center for Health Care Evaluation in Palo Alto, CA. All other authors are part of the VA Puget Sound Health Care System, and Dr. Bradley is part of VA/HSR&D’s Substance Use Disorders Quality Enhancement Research Initiative (SUD-QUERI).