Alcohol Use in Severely Injured Trauma Patients

Overview

Journal Sci Rep

Specialty Science

Date 2020 Oct 22

PMID 33087781

Citations 14

Authors

Antti Riuttanen

Saara J Jantti

Ville M Mattila

Affiliations

Soon will be listed here.

Abstract

Alcohol is a major risk factor for several types of injuries, and it is associated with almost all types and mechanisms of injury. The focus of the study was to evaluate alcohol use in severely injured trauma patients with New Injury Severity Score (NISS) of 16 or over, and to compare mortality, injury severity scores and mechanisms and patterns of injury between patients with positive and negative blood alcohol levels (BAL). Medical histories of all severely injured trauma patients (n = 347 patients) enrolled prospectively in Trauma Register of Tampere University Hospital (TAUH) between January 2016 to December 2017 were evaluated for alcohol/substance use, injury mechanism, mortality and length of stay in Intensive Care Unit (ICU). A total of 252 of 347 patients (72.6%) were tested for alcohol with either direct blood test (50.1%, 174/347), breathalyser (11.2%, 39/347), or both (11.2%, 39/347). After untested patients were excluded, 53.5% of adult patients (18-64 years), 20.5% of elderly patients (above 65 years) and 13.3% of paediatric patients (0-17 years) tested BAL positive. The mean measured BAL for the study population was 1.9 g/L. The incidence of injuries was elevated in the early evenings and the relative proportion of BAL positive patients was highest (67.7%) during the night. Injury severity scores (ISS or NISS) and length of stay in ICU were not adversely affected by alcohol use. Mortality was higher in patients with negative BAL (18.2% vs. 7.7%, p = 0.0019). Falls from stairs, and assaults were more common in patients with positive BAL (15.4% vs. 5.4% and 8.7% vs. 2.7%, p < 0.006, respectively). There were no notable differences in injury patterns between the two groups. Alcohol use among severely injured trauma patients is common. Injury mechanisms between patients with positive and negative BAL have differences, but alcohol use will not increase mortality or prolong length of stay in ICU. This study supports the previously reported findings that BAL is not a suitable marker to assess patient mortality in trauma setting.

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References

Osler T, Baker S, Long W . A modification of the injury severity score that both improves accuracy and simplifies scoring. J Trauma. 1998; 43(6):922-5; discussion 925-6. DOI: 10.1097/00005373-199712000-00009. View

Kankaanpaa A, Ariniemi K, Heinonen M, Kuoppasalmi K, Gunnar T . Use of illicit stimulant drugs in Finland: a wastewater study in ten major cities. Sci Total Environ. 2013; 487:696-702. DOI: 10.1016/j.scitotenv.2013.11.095. View

Borges G, Cherpitel C, Mittleman M . Risk of injury after alcohol consumption: a case-crossover study in the emergency department. Soc Sci Med. 2004; 58(6):1191-200. DOI: 10.1016/s0277-9536(03)00290-9. View

Ahmed N, Greenberg P . Patient mortality following alcohol use and trauma: a propensity-matched analysis. Eur J Trauma Emerg Surg. 2017; 45(1):151-158. DOI: 10.1007/s00068-017-0794-6. View

Zeckey C, Dannecker S, Hildebrand F, Mommsen P, Scherer R, Probst C . Alcohol and multiple trauma: is there an influence on the outcome?. Alcohol. 2010; 45(3):245-51. DOI: 10.1016/j.alcohol.2010.08.004. View

Taylor B, Irving H, Kanteres F, Room R, Borges G, Cherpitel C . The more you drink, the harder you fall: a systematic review and meta-analysis of how acute alcohol consumption and injury or collision risk increase together. Drug Alcohol Depend. 2010; 110(1-2):108-16. PMC: 2887748. DOI: 10.1016/j.drugalcdep.2010.02.011. View

Shyhalla K . Alcohol involvement and other risky driver behaviors: effects on crash initiation and crash severity. Traffic Inj Prev. 2014; 15(4):325-34. DOI: 10.1080/15389588.2013.822491. View

Rehm J, Room R, Monteiro M, Gmel G, Graham K, Rehn N . Alcohol as a risk factor for global burden of disease. Eur Addict Res. 2003; 9(4):157-64. DOI: 10.1159/000072222. View

Agardh E, Danielsson A, Ramstedt M, Holm A, Diderichsen F, Juel K . Alcohol-attributed disease burden in four Nordic countries: a comparison using the Global Burden of Disease, Injuries and Risk Factors 2013 study. Addiction. 2016; 111(10):1806-13. PMC: 5089612. DOI: 10.1111/add.13430. View

10.

Kalsi J, Selander T, Tervo T . Alcohol policy and fatal alcohol-related crashes in Finland 2000-2016. Traffic Inj Prev. 2018; 19(5):476-479. DOI: 10.1080/15389588.2018.1443325. View

11.

Kowalenko T, Burgess B, Szpunar S, Irvin-Babcock C . Alcohol and trauma--in every age group. Am J Emerg Med. 2013; 31(4):705-9. DOI: 10.1016/j.ajem.2012.12.032. View

12.

Love A, Baz-Lomba J, Reid M, Kankaanpaa A, Gunnar T, Dam M . Analysis of stimulant drugs in the wastewater of five Nordic capitals. Sci Total Environ. 2018; 627:1039-1047. DOI: 10.1016/j.scitotenv.2018.01.274. View

13.

Savola O, Niemela O, Hillbom M . Alcohol intake and the pattern of trauma in young adults and working aged people admitted after trauma. Alcohol Alcohol. 2005; 40(4):269-73. DOI: 10.1093/alcalc/agh159. View

14.

Kuendig H, Hasselberg M, Laflamme L, Daeppen J, Gmel G . Acute alcohol consumption and injury: risk associations and attributable fractions for different injury mechanisms. J Stud Alcohol Drugs. 2008; 69(2):218-26. DOI: 10.15288/jsad.2008.69.218. View

15.

. Rating the severity of tissue damage. I. The abbreviated scale. JAMA. 1971; 215(2):277-80. DOI: 10.1001/jama.1971.03180150059012. View

16.

Borges G, Cherpitel C, Medina-Mora M, Mondragon L . Violence related injuries in the emergency room: alcohol, depression, and conduct problems. Subst Use Misuse. 2004; 39(6):911-30. DOI: 10.1081/ja-120030893. View

17.

Benson C, Weinberg J, Narsule C, Brahmbhatt T . A comparison of alcohol positive and alcohol negative trauma patients requiring an emergency laparotomy. Am J Emerg Med. 2017; 36(7):1139-1144. DOI: 10.1016/j.ajem.2017.11.028. View

18.

Johnston J, McGovern S . Alcohol related falls: an interesting pattern of injuries. Emerg Med J. 2004; 21(2):185-8. PMC: 1726307. DOI: 10.1136/emj.2003.006130. View

19.

Kankaanpaa A, Ariniemi K, Heinonen M, Kuoppasalmi K, Gunnar T . Current trends in Finnish drug abuse: Wastewater based epidemiology combined with other national indicators. Sci Total Environ. 2016; 568:864-874. DOI: 10.1016/j.scitotenv.2016.06.060. View

20.

Hadjizacharia P, OKeeffe T, Plurad D, Green D, Brown C, Chan L . Alcohol exposure and outcomes in trauma patients. Eur J Trauma Emerg Surg. 2011; 37(2):169-75. PMC: 3150794. DOI: 10.1007/s00068-010-0038-5. View