Effects of ethanol intoxication and gender on blood coagulation.
BACKGROUND
Ethanol intoxication is a common contributor to traumatic injury. It is unknown whether ethanol consumption contributes to the coagulation differences seen between men and women after trauma. Our aim was to examine the combined effect of ethanol intoxication and gender on coagulation.


METHODS
Fifty-eight healthy subjects participated and chose to enter into a control group (CG; n = 20; 10 men and 10 women) or drinking group (DG; n = 38; 20 men and 18 women). Venous blood samples for thrombelastography, plasminogen activator inhibitor, thrombin-antithrombin complex, and tissue plasminogen activator were drawn at the beginning of the study. Subjects then interacted in a social atmosphere for at least 2 hours, eating and consuming alcoholic (DG) or nonalcoholic (CG) beverages. After 2 hours, blood alcohol level was determined and blood was drawn for a second set of coagulation studies.


RESULTS
Demographics were similar between groups except for age (36.7 years CG vs. 29.9 years DG; p = 0.009). All baseline thrombelastography measurements were similar between the CG and DG. Blood alcohol levels in the DG were similar between genders at the end of study. At the end of study, a decreased rate of fibrin formation, decreased clot strength, and a decreased rate of fibrin cross-linking was seen in men but not in women. Fibrinolysis was inhibited in drinkers compared with controls.


CONCLUSIONS
Consumption of commonly ingested quantities of alcohol correlated with the development of a hypocoagulable state in men but had no effect on coagulation status in women. This phenomenon may contribute to differences in post-trauma coagulation status previously noted between genders.
Spoerke
Nicholas
N
Division of Trauma and Critical Care, Oregon Health and Science University, Portland, Oregon, USA. spoerken@ohsu.edu
Underwood
Samantha
S
Differding
Jerome
J
Van
Phil
P
Sambasivan
Chitra
C
Shapiro
David
D
Schreiber
Martin
M
D000328:Adult; D000435:Alcoholic Intoxication / Q000097:blood / Q000150:complications; D000990:Antithrombin III; D001778:Blood Coagulation Disorders / Q000097:blood* / Q000209:etiology; D016022:Case-Control Studies; D000431:Ethanol / Q000097:blood*; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D008297:Male; D009922:Oregon; D010447:Peptide Hydrolases / Q000097:blood; D015849:Plasminogen Inactivators / Q000097:blood; D011446:Prospective Studies; D012727:Sex Characteristics; D018709:Statistics, Nonparametric; D013916:Thrombelastography; D010959:Tissue Plasminogen Activator / Q000097:blood; D014947:Wounds and Injuries / Q000209:etiology
D015849:Plasminogen Inactivators; C046193:antithrombin III-protease complex; D000431:Ethanol; D000990:Antithrombin III; D005337:Fibrin; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator