title: Adverse clinical outcomes associated with elevated blood alcohol levels at the time of burn injury.
abstract: 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.
authors.affiliation: Department of Surgery, Burn Shock Trauma Institute, Loyola University Medical Center, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois 60153, USA.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Silver
authors.forename: Joslyn M
authors.initials: JM
authors.lastname: Albright
authors.forename: Carol R
authors.initials: CR
authors.lastname: Schermer
authors.forename: Marcia
authors.initials: M
authors.lastname: Halerz
authors.forename: Peggie
authors.initials: P
authors.lastname: Conrad
authors.forename: Paul D
authors.initials: PD
authors.lastname: Ackerman
authors.forename: Linda
authors.initials: L
authors.lastname: Lau
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Emanuele
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Kovacs
authors.forename: Richard L
authors.initials: RL
authors.lastname: Gamelli
mesh_terms: 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
chemical_list: D000431:Ethanol