PurposeTo examine the association of blood alcohol content (BAC) on hospital-based outcomes and imaging utilization for patients <21 years admitted to a level I trauma center. MethodsRetrospective analysis of alcohol-involved injuries in patients 13–20 years, admitted to a level I trauma center from 1996 to 2010. An injury was considered alcohol involved if the patient had a BAC > 0. Multivariable logistic regression was used to compare mortality, discharge destination (home and skilled nursing facility), intensive care unit admission, and operating room use between patients with and without positive BAC for patients 13–15, 16–17, and 18–20 years. Multivariable linear regression was used to compare length of hospitalization. Finally, multivariable negative binomial regression evaluated radiology resource utilization (x-ray, computed tomography [CT], and magnetic resonance imaging). ResultsA total of 7,663 patients, 13–20 years old, were admitted over the study period. A positive BAC was reported in 19% of these patients. In general, the presence of alcohol was not associated with mortality rate, length of hospitalization, intensive care unit, and operating room use or discharge status for any age group. However, the presence of alcohol was associated with higher utilization of head (incidence rate ratio [IRR] 1.13, 95% confidence interval [CI] 1.02–1.26), cervical spine (IRR 1.10, 95% CI 1.01–1.22), and thoracic (IRR 1.30, 95% CI 1.05–1.63) CTs in young adults 18–20 years. No differences in CT use were observed in patients 13–15 or 16–17 years. ConclusionsPositive BAC was not significantly associated with adverse outcomes or resource utilization in younger trauma patients. However, the use of certain body region CTs was associated with positive BAC in patients 18–20 years.