Effect of elevated serum alcohol level on the outcome of severely injured patients.
Emerg Med J
; 31(10): 813-7, 2014 Oct.
Article
em En
| MEDLINE
| ID: mdl-23850886
ABSTRACT
BACKGROUND:
The influence of high blood alcohol level (BAL) on the outcome of severely injured patients and the corresponding pathophysiological changes is a controversial issue.OBJECTIVE:
To carry out a prognostic study to compare the physiological values and short-term outcome of severely injured patients depending on their serum alcohol level.METHODS:
A total of 383 severely injured patients with an Injury Severity Score (ISS) ≥17 were admitted to the trauma division between October 2008 and December 2009 and enrolled into this study. Patients were grouped according to their BAL (>0.5,'BAL positive' vs <0.5,'BAL negative'). Trauma mechanism, pattern of injury and its treatment, and a course of intensive care treatment, physiological parameters and outcome with respect to mortality were analysed.RESULTS:
Both groups had similar ISS. In comparison with the BAL-negative group, patients in the BAL-positive group had a significantly lower Glasgow Coma Scale score (9.64 vs 12 points; p=0.005) and, although not significant, a trend towards higher values of the Abbreviated Injury Score for the head (3.29 vs 2.81 points; p=0.146). Furthermore, significantly higher lactate (3.11â mmol/L vs 2.02â mmol/L; p<0.001) levels and lower median arterial pressure values (87.9â mmâ Hg vs 99.4â mmâ Hg; p=0.006) were seen in the BAL-positive group at day of admission. However, the overall in-hospital mortality was comparable to that in BAL-negative patients (19.6% vs 21.5%). Similarly, hospital stay (15.29 vs 17.55â days) and duration of intensive care unit treatment (8.53 vs 8.36â days) were not significantly affected by a high BAL upon admission.CONCLUSIONS:
Severely injured patients with a raised BAL have a higher incidence of severe traumatic brain injury and worse initial physiological parameters. However, the survival rate and in-hospital stay is not influenced. This supports the theory of a neuroprotective role of alcohol.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismo Múltiplo
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Etanol
Tipo de estudo:
Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Emerg Med J
Ano de publicação:
2014
Tipo de documento:
Article