Nils Wagner1, Borna Relja2, Thomas Lustenberger2, Max Leiblein2, Sebastian Wutzler3, Rolf Lefering4, Ingo Marzi2. 1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany. nils.wagner@kgu.de. 2. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe-University, Frankfurt, Germany. 3. Department of Trauma, Hand and Orthopaedic Surgery, Helios Dr. Horst Schmidt Hospital, Wiesbaden, Germany. 4. IFOM, Institute for Research in Operative Medicine, Faculty of Health, University Witten/Herdecke, Ostmerheimer Straße 200, 51109, Cologne, Germany.
Abstract
BACKGROUND AND PURPOSE: In the diagnosis and treatment of trauma patients, numerous individual and trauma-related factors must be considered, all of which may influence the outcome. Although alcohol exposure is a major risk factor for an accident, its influence on the outcome is unclear. This matched-pair analysis investigates the hypothesis that alcohol has no negative impact on the outcome of trauma patients. MATERIALS AND METHODS: In a retrospective matched-pair analysis of the multi-centre database of the TraumaRegister DGU® patients with a maximum Abbreviated Injury Scale (MAIS) of 3 or greater from the years 2015 and 2016 with an alcohol level ≥ 0.5‰ were compared to patients with a measured alcohol level of 0.0‰. The patients were matched according to age, gender, AIS body regions (head, thorax, abdomen, pelvis/extremities) and survival presumption (Revised Injury Severity Classification Score (RISC) II the TraumaRegister ervals). RESULTS: After matching, a total of 834 patients were enrolled, with 417 patients in group with positive blood alcohol levels (BAL +) with a median alcohol level of 1.82‰ and 417 patients in the negative-alcohol group (BAL -). As a mechanism of injury, the BAL + group showed more often penetrating injuries, pedestrian accidents and low energy falls compared to car and motorcycle accidents in the BAL - group. BAL + patients were significantly less sedated (BAL -: 66.7% vs. BAL + : 56.2%, p = 0.002), less frequently transported by rescue helicopter, were more frequently hypotensive (BAL -: 42 patients (10.3%) vs. BAL + : 61 patients (15.2%), p = 0.045, Table 2) and exhibited lower base excess levels associated with an acidotic metabolic status compared to sober patients (acidosis: BAL -: 24 patients (6.1%) vs. BAL + : 61 patients (17.2%), p < 0.001). There was no difference regarding in-hospital complications, length of stay or mortality rate. CONCLUSIONS AND IMPLICATIONS: Our data demonstrate that alcohol exposure in trauma patients has no impact on complication or mortality rates. On the other hand, there are initially clear differences in the mechanism of injury, sedation, mode of transport and the acid-base balance.
BACKGROUND AND PURPOSE: In the diagnosis and treatment of traumapatients, numerous individual and trauma-related factors must be considered, all of which may influence the outcome. Although alcohol exposure is a major risk factor for an accident, its influence on the outcome is unclear. This matched-pair analysis investigates the hypothesis that alcohol has no negative impact on the outcome of traumapatients. MATERIALS AND METHODS: In a retrospective matched-pair analysis of the multi-centre database of the TraumaRegister DGU® patients with a maximum Abbreviated Injury Scale (MAIS) of 3 or greater from the years 2015 and 2016 with an alcohol level ≥ 0.5‰ were compared to patients with a measured alcohol level of 0.0‰. The patients were matched according to age, gender, AIS body regions (head, thorax, abdomen, pelvis/extremities) and survival presumption (Revised Injury Severity Classification Score (RISC) II the TraumaRegister ervals). RESULTS: After matching, a total of 834 patients were enrolled, with 417 patients in group with positive blood alcohol levels (BAL +) with a median alcohol level of 1.82‰ and 417 patients in the negative-alcohol group (BAL -). As a mechanism of injury, the BAL + group showed more often penetrating injuries, pedestrian accidents and low energy falls compared to car and motorcycle accidents in the BAL - group. BAL + patients were significantly less sedated (BAL -: 66.7% vs. BAL + : 56.2%, p = 0.002), less frequently transported by rescue helicopter, were more frequently hypotensive (BAL -: 42 patients (10.3%) vs. BAL + : 61 patients (15.2%), p = 0.045, Table 2) and exhibited lower base excess levels associated with an acidotic metabolic status compared to sober patients (acidosis: BAL -: 24 patients (6.1%) vs. BAL + : 61 patients (17.2%), p < 0.001). There was no difference regarding in-hospital complications, length of stay or mortality rate. CONCLUSIONS AND IMPLICATIONS: Our data demonstrate that alcohol exposure in traumapatients has no impact on complication or mortality rates. On the other hand, there are initially clear differences in the mechanism of injury, sedation, mode of transport and the acid-base balance.
Entities:
Keywords:
Acidose; Alcohol; Base excess; Outcome; Trauma patients
Authors: Eric O Yeates; Areg Grigorian; Morgan Schellenberg; Natthida Owattanapanich; Galinos Barmparas; Daniel Margulies; Catherine Juillard; Kent Garber; Henry Cryer; Areti Tillou; Sigrid Burruss; Ryan Arthur Figueras; Georgi Mladenov; Megan Brenner; Christopher Firek; Todd Costantini; Jarrett Santorelli; Terry Curry; Diane Wintz; Walter L Biffl; Kathryn B Schaffer; Thomas K Duncan; Casey Barbaro; Graal Diaz; Arianne Johnson; Justine Chinn; Ariana Naaseh; Amanda Leung; Christina Grabar; Jeffry Nahmias Journal: Eur J Trauma Emerg Surg Date: 2021-05-25 Impact factor: 3.693