Il-Jae Wang1,2, Byung-Kwan Bae1, Young Mo Cho1, Suck Ju Cho1,3, Seok-Ran Yeom1,3, Sang-Bong Lee4, Mose Chun5, Hyerim Kim2,6, Hyung-Hoi Kim2,6, Sun Min Lee7, Up Huh8, Soo Young Moon2,6. 1. Department of Emergency Medicine, Pusan National University Hospital, Busan, Republic of Korea. 2. Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea. 3. Department of Emergency Medicine, Pusan National University School of Medicine, Gyeongsangnam-do, Yangsan, Republic of Korea. 4. Department of Trauma Surgery, Pusan National University Hospital, Busan, Republic of Korea. 5. Department of Emergency Medicine, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Yangsan, Republic of Korea. 6. Department of Laboratory Medicine, Pusan National University Hospital, Busan, Republic of Korea. 7. Department of Laboratory Medicine, Pusan National University Yangsan Hospital, Gyeongsangnam-do, Yangsan, Republic of Korea. 8. Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Republic of Korea.
Abstract
BACKGROUND: The effect of alcohol on the outcome and fibrinolysis phenotype in trauma patients remains unclear. Hence, we performed this study to determine whether alcohol is a risk factor for mortality and fibrinolysis shutdown in trauma patients. MATERIALS AND METHODS: A total of 686 patients who presented to our trauma center and underwent rotational thromboelastometry were included in the study. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to determine whether alcohol was an independent risk factor for in-hospital mortality and fibrinolysis shutdown. RESULTS: The rate of in-hospital mortality was 13.8% and blood alcohol was detected in 27.7% of the patients among our study population. The patients in the alcohol-positive group had higher mortality rate, higher clotting time, and lower maximum lysis, more fibrinolysis shutdown, and hyperfibrinolysis than those in the alcohol-negative group. In logistic regression analysis, blood alcohol was independently associated with in-hospital mortality (odds ratio [OR] 2.578; 95% confidence interval [CI], 1.550-4.288) and fibrinolysis shutdown (OR 1.883 [95% CI, 1.286-2.758]). Within the fibrinolysis shutdown group, blood alcohol was an independent predictor of mortality (OR 2.168 [95% CI, 1.030-4.562]). CONCLUSIONS: Alcohol is an independent risk factor for mortality and fibrinolysis shutdown in trauma patients. Further, alcohol is an independent risk factor for mortality among patients who experienced fibrinolysis shutdown.
BACKGROUND: The effect of alcohol on the outcome and fibrinolysis phenotype in traumapatients remains unclear. Hence, we performed this study to determine whether alcohol is a risk factor for mortality and fibrinolysis shutdown in traumapatients. MATERIALS AND METHODS: A total of 686 patients who presented to our trauma center and underwent rotational thromboelastometry were included in the study. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to determine whether alcohol was an independent risk factor for in-hospital mortality and fibrinolysis shutdown. RESULTS: The rate of in-hospital mortality was 13.8% and blood alcohol was detected in 27.7% of the patients among our study population. The patients in the alcohol-positive group had higher mortality rate, higher clotting time, and lower maximum lysis, more fibrinolysis shutdown, and hyperfibrinolysis than those in the alcohol-negative group. In logistic regression analysis, blood alcohol was independently associated with in-hospital mortality (odds ratio [OR] 2.578; 95% confidence interval [CI], 1.550-4.288) and fibrinolysis shutdown (OR 1.883 [95% CI, 1.286-2.758]). Within the fibrinolysis shutdown group, blood alcohol was an independent predictor of mortality (OR 2.168 [95% CI, 1.030-4.562]). CONCLUSIONS:Alcohol is an independent risk factor for mortality and fibrinolysis shutdown in traumapatients. Further, alcohol is an independent risk factor for mortality among patients who experienced fibrinolysis shutdown.
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