Extreme blood alcohol level is associated with increased resource use in trauma patients.
This study aims to examine resource utilization and outcomes of trauma patients with extremely high blood alcohol concentrations. We hypothesized that higher blood alcohol concentration (BAC) predicts greater resource utilization and poorer outcomes. A retrospective analysis was performed on trauma patients admitted to an urban Level I trauma center over a 5-year period. Admission BAC categories were constructed using standard laboratory norms and legal definitions. Demographic data, premorbid conditions, injury severity scores (ISS), resource utilization (intensive care unit (ICU) admission rates/length of stay, total hospital days, use of consultants), and mortality were analyzed. Positive BAC on admission was associated with increased ISS (P < 0.001), length of stay (P < 0.003), and total ICU days (P < 0.001). Increased BAC admission level of patients was associated with a decreased ISS score (P = 0.0073), a higher probability of ICU admission (P = 0.0013), and an increased percentage of ICU days (P = 0.001). A positive BAC at admission was a significant predictor of both ICU admission and mortality (odds ratios 1.72 and 1.27, respectively). This study demonstrates that a positive BAC is associated with increased ISS, increased resource utilization, and worsened outcomes. Extreme levels of BAC are associated with increased resource utilization despite lower injury severity scores.
Department of Surgery, Banner Good Samaritan Medical Center, Phoenix, Arizona 85006, USA.
Alissa
A
Swearingen
Vafa
V
Ghaemmaghami
Terrence
T
Loftus
Christopher J
CJ
Swearingen
Helen
H
Salisbury
Richard D
RD
Gerkin
John
J
Ferrara
D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology* / Q000401:mortality; D001130:Arizona / Q000453:epidemiology; D000431:Ethanol / Q000097:blood; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy
D000431:Ethanol