Salomon Puyana1,2, Samuel Ruiz1, Francisco Amador3, Elizabeth Young4, Shaikh Hai1, Mark Mckenney1,5, Rizal Lim1,4, Haaris Mir1,4. 1. Department of Surgery, Kendall Regional Medical Center, Miami, Florida. 2. Department of Plastic Surgery, Tulane Medical Center, New Orleans, Louisiana. 3. Department of Research, Cleveland Clinic Foundation, Weston, Florida. 4. Burn & Reconstructive Centers of Florida, Miami, Florida. 5. Department of Surgery, University of South Florida, Tampa, Florida.
Abstract
Background: Alcohol use has been associated with poor wound healing in traumatic injuries as it impairs immune function and lowers leukocyte production. The aim of this study is to describe the association of alcohol use on the outcomes of patients with burn injuries. It is proposed that the use of alcohol can have a detrimental effect on burn patient outcomes. Methods: A retrospective review of the American Burn Association Burn Registry from 2002 through 2011 was conducted. Patients were stratified into 2 groups: burn patients with a blood alcohol level above the legal limit 0.08 mg/dl on admission (group 1) vs burn patients with a blood alcohol level below the legal limit of 0.08 mg/dl on admission (group 2). The outcome measures included in-hospital mortality rate, hospital length of stay (LOS), intensive care unit (ICU) LOS, and total days on a ventilator. Results: A total of 11,286 burn patients met the inclusion criteria. There were a total of 1,544 patients in group 1 and a total of 9,742 patients in group 2. The percentage of total body surface area (TBSA) involvement of the burns was statistically similar in both groups, with an average of 2.08% in group 1 and 2.32% in group 2. There was a significantly higher ICU LOS at 5.91 days in group 1 compared to 3.66 in group 2. The days on a ventilator were significantly higher in group 1 at 5.67 days versus group 2 at 3.06 days. The in-hospital mortality was also significantly higher in group 1 at 4.86% compared to group 2 at 3.91%. Conclusion: Burn patients who tested above the legal limit for alcohol on admission were associated with increased inpatient mortality, as well as increased ICU LOS and total days on a ventilator. An elevated admission blood alcohol level may be an independent predictor of worse outcome in patients with burn injury, leading to an increase in resource needs and health care costs.
Background: Alcohol use has been associated with poor wound healing in traumatic injuries as it impairs immune function and lowers leukocyte production. The aim of this study is to describe the association of alcohol use on the outcomes of patients with burn injuries. It is proposed that the use of alcohol can have a detrimental effect on burn patient outcomes. Methods: A retrospective review of the American Burn Association Burn Registry from 2002 through 2011 was conducted. Patients were stratified into 2 groups: burn patients with a blood alcohol level above the legal limit 0.08 mg/dl on admission (group 1) vs burn patients with a blood alcohol level below the legal limit of 0.08 mg/dl on admission (group 2). The outcome measures included in-hospital mortality rate, hospital length of stay (LOS), intensive care unit (ICU) LOS, and total days on a ventilator. Results: A total of 11,286 burn patients met the inclusion criteria. There were a total of 1,544 patients in group 1 and a total of 9,742 patients in group 2. The percentage of total body surface area (TBSA) involvement of the burns was statistically similar in both groups, with an average of 2.08% in group 1 and 2.32% in group 2. There was a significantly higher ICU LOS at 5.91 days in group 1 compared to 3.66 in group 2. The days on a ventilator were significantly higher in group 1 at 5.67 days versus group 2 at 3.06 days. The in-hospital mortality was also significantly higher in group 1 at 4.86% compared to group 2 at 3.91%. Conclusion: Burn patients who tested above the legal limit for alcohol on admission were associated with increased inpatient mortality, as well as increased ICU LOS and total days on a ventilator. An elevated admission blood alcohol level may be an independent predictor of worse outcome in patients with burn injury, leading to an increase in resource needs and health care costs.
Authors: Geoffrey M Silver; Joslyn M Albright; Carol R Schermer; Marcia Halerz; Peggie Conrad; Paul D Ackerman; Linda Lau; Mary Ann Emanuele; Elizabeth J Kovacs; Richard L Gamelli Journal: J Burn Care Res Date: 2008 Sep-Oct Impact factor: 1.845