title: Effects of positive blood alcohol concentration on outcome and systemic interleukin-6 in major trauma patients.
abstract: BACKGROUND
  The influence of alcohol on the outcome after major trauma remains controversial. In several recent studies, alcohol has been associated with neuroprotective effects in head injuries, while others reported negative or no effects on survival and/or the in-hospital stay in major trauma patients (TP). The purpose of this study was to examine the relationship of alcohol with injury characteristics and outcome as well as to analyze possible anti-inflammatory properties in major TP.
  
  
  METHODS
  184 severely injured TP with an Injury Severity Score (ISS) ≥16 were successively enrolled. All patients had measured blood alcohol concentration (BAC). Patients were grouped according to their positive BAC (>0.5‰, BAC) vs. <0.5‰ alcohol (no BAC) upon arrival at the emergency department (ED). Injury characteristics, physiologic parameters and outcome with respect to organ or multiple organ failure (MOF), SIRS, sepsis, pneumonia, ARDS or mortality were assessed. Systemic levels of interleukin (IL)-6 at ED were determined.
  
  
  RESULTS
  Forty-nine TP had positive BAC without chronic alcohol abuse history and 135 patients had BAC levels below 0.5‰. Overall injury severity and age were comparable in both groups. No BAC TP received significantly higher numbers of packed red blood cells and fresh frozen plasma (transfused within the initial 24h or in total) compared to BAC TP. Organ failure, MOF, SIRS, sepsis, pneumonia, ARDS and the in-hospital mortality were not different between both groups. Trauma patients with positive BAC had significantly decreased leukocyte numbers and systemic IL-6 levels compared to no BAC group. There was a significant positive correlation between leukocyte counts and IL-6 as well as BAC and leukocytes. BAC levels did not correlate with IL-6.
  
  
  CONCLUSIONS
  Positive BAC is associated with reduced leukocyte numbers and lowered systemic IL-6 levels at admittance indicating immune-suppressive effects of alcohol in major trauma patients.
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany. Electronic address: info@bornarelja.com.
authors: B
authors: B
authors: Relja
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: J
authors: J
authors: Menke
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: N
authors: N
authors: Wagner
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: B
authors: B
authors: Auner
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: M
authors: M
authors: Voth
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: C
authors: C
authors: Nau
authors: Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.
authors: I
authors: I
authors: Marzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000097:blood* / Q000401:mortality; D000893:Anti-Inflammatory Agents / Q000097:blood* / Q000494:pharmacology; D000067401:Blood Alcohol Content; D000431:Ethanol / Q000097:blood* / Q000494:pharmacology; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D015601:Injury Severity Score; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D018696:Neuroprotective Agents / Q000097:blood* / Q000494:pharmacology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000067401:Blood Alcohol Content; C508600:IL6 protein, human; D015850:Interleukin-6; D018696:Neuroprotective Agents; D000431:Ethanol
keywords: Alcohol; IL-6; Inflammation; Outcome; SIRS; Trauma