Alcohol exposure and outcomes in trauma patients

P. Hadjizacharia, T. O'Keeffe, D. S. Plurad, D. J. Green, C. V R Brown, L. S. Chan, D. Demetriades, P. Rhee

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Objective: To determine the injury patterns, complications, and mortality after alcohol consumption in trauma patients. Methods: The Trauma Registry at an American College of Surgeons (ACS) level I center was queried for all patients with a toxicology screen admitted between 1st January 2002 and 31st December 2005. Alcohol-positive (AP) patients were matched to control patients who had a completely negative screen (AN) using age, gender, mechanism, Injury Severity Score (ISS), head Abbreviated Injury Scale (AIS), chest AIS, abdominal AIS, and extremity AIS. Injuries and outcomes were compared between the groups. Results: As many as 5,317 patients had toxicology data, of which 471 (8. 9%) had a positive alcohol screen (AP). A total of 386 AP patients were then matched to 386 control (AN) patients. The AP group had a significantly higher mortality than the AN group overall (23 vs. 13%; p 0. 001), and by ISS stratification: ISS 16 (6 vs. 0. 4%; p 0. 001), ISS 16-25 (53 vs. 28%; p = 0. 01), and ISS > 25 (90 vs. 67%; p = 0. 01). AP patients had a higher incidence of admission systolic blood pressure 90 (18 vs. 10%; p 0. 001) and Glasgow Coma Scale (GCS) score ≤ 8 (25 vs. 17%; p = 0. 002). AN patients had a significantly higher incidence of hemopneumothorax (11 vs. 7%; p = 0. 03), while AP patients had a higher incidence of cardiac arrest (8 vs. 3%; p = 0. 004). There was no difference in intensive care unit (ICU) and hospital length of stay. Conclusion: In a mixed population of trauma patients, an AP screen is associated with an increased incidence of admission hypotension and depressed GCS score. In this case-matched study, alcohol exposure appeared to increase mortality after injury.

Original languageEnglish (US)
Pages (from-to)169-175
Number of pages7
JournalEuropean Journal of Trauma and Emergency Surgery
Volume37
Issue number2
DOIs
StatePublished - Apr 1 2011

Keywords

  • Alcohol
  • Complications
  • Injury
  • Mortality
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Orthopedics and Sports Medicine
  • Critical Care and Intensive Care Medicine

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    Hadjizacharia, P., O'Keeffe, T., Plurad, D. S., Green, D. J., Brown, C. V. R., Chan, L. S., Demetriades, D., & Rhee, P. (2011). Alcohol exposure and outcomes in trauma patients. European Journal of Trauma and Emergency Surgery, 37(2), 169-175. https://doi.org/10.1007/s00068-010-0038-5