Alcohol intoxication may be associated with reduced truncal injuries after blunt trauma.
BACKGROUND
Prior studies suggest that positive blood alcohol concentration (BAC) is associated with lower mortality after motor vehicle collisions (MVCs). We investigated the relationship between increasing BAC and mortality after MVC.


METHODS
A retrospective review of the Los Angeles County trauma database from January 2003 to December 2008 was performed. MVC patients greater than or equal to 16 years of age with admission BAC were considered. Patients were stratified by BAC as follows: BAC0 (<.01), BAC1 (.01 to .08), BAC2 (.09 to .16), BAC3 (.17 to .24), BAC4 (.25 to .32), and BAC5 (>.32). Logistic regression was used to determine predictors of mortality.


RESULTS
A total of 12,540 patients were included. Overall mortality rate was 2.2%. Mortality was lowest in BAC3 (1.6%) and BAC4 (1.3%), although the difference among all groups was not statistically significant (P = .07). Decreased rates of Injury Severity Score greater than or equal to 16 were noted with increasing BAC, which was largely because of reduced chest and abdomen/pelvis Abbreviated Injury Scale. Adjusted mortality was lower in BAC3 and BAC4 (both adjusted odds ratio .4, P < .001).


CONCLUSIONS
A protective effect of alcohol after MVC may be related to decreased truncal injury burden rather than protection after head injury.
Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Douglas Z
DZ
Liou
Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Galinos
G
Barmparas
Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Andrea
A
Zaw
Department of Surgery, Division of Trauma and Critical Care, Broward Medical Center, Fort Lauderdale, FL, USA.
Marko
M
Bukur
Department of Surgery, Division of Trauma and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Ali
A
Salim
Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: Eric.Ley@cshs.org.
Eric J
EJ
Ley
D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D000435:Alcoholic Intoxication; D006259:Craniocerebral Trauma / Q000401:mortality*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D060726:Torso / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000401:mortality*
Alcohol intoxication; Blunt trauma; Motor vehicle collision