Adverse clinical outcomes associated with elevated blood alcohol levels at the time of burn injury.
Elevated blood alcohol content (BAC) on admission is associated with poorer outcomes, larger burns and more inhalation injury. This study's purpose was to examine the effects of alcohol through a matched case-controlled study, measuring early and extended markers of clinical outcomes. The hypothesis was that patients with an elevated admission BAC would require more resuscitation and have a longer hospital stay. Admissions 16 to 75 years of age with 15 to 75% TBSA and admission BACs were identified. Patients with BAC >30 mg/dl (BAC+, cases) were matched with patients with undetectable BAC (BAC-, controls), according to age, sex, TBSA, inhalation injury and mechanism. Screening identified 258 patients, 146 with admission BACs. Twenty-seven had a BAC > or = 30 mg/dl. There were 24 matched pairs. At 24 hours, BAC+ group had larger acute physiology and chronic health evaluation II scores (23.33 vs 18.75, P < .05), fluid requirements (5.25 vs 3.82 L (cc/kg/TBSA), P < .05), and base deficit (11.15 vs 7.15, P < .05). The duration of mechanical ventilation (14.85 vs 4.23 days, P < .05), intensive care unit length of stay (22.85 vs 9.38, P < .05), hospital length of stay (28.95 vs 15.68, P < .05), and mean hospital charges ($239,507 vs $144,598, P < .05) were increased in the BAC+ patients. Despite matched baseline injury characteristics, elevated BAC was associated with poorer short term and extended clinical outcomes, illustrating the impact of alcohol intoxication on physiologic derangement after burn injury.
Silver
Geoffrey M
GM
Department of Surgery, Burn Shock Trauma Institute, Loyola University Medical Center, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois 60153, USA.
Albright
Joslyn M
JM
Schermer
Carol R
CR
Halerz
Marcia
M
Conrad
Peggie
P
Ackerman
Paul D
PD
Lau
Linda
L
Emanuele
Mary Ann
MA
Kovacs
Elizabeth J
EJ
Gamelli
Richard L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000435:Alcoholic Intoxication / Q000097:blood* / Q000150:complications*; D002056:Burns / Q000453:epidemiology*; D016022:Case-Control Studies; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D000431:Ethanol