Influence of alcohol use on mortality and expenditure during hospital admission: a cross-sectional study.
This study was designed to investigate the effect of alcohol intoxication on clinical presentation of hospitalised adult trauma patients at a Level I trauma centre using propensity score matching.



Cross-sectional study.



Taiwan.



Detailed data of 929 hospitalised adult trauma patients with alcohol intoxication, aged 20-65 years, and 10 104 corresponding patients without alcohol intoxication were retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2014. Alcohol intoxication was defined as a blood alcohol concentration (BAC) ≥50 mg/dL.



In-hospital mortality and expenditure.



Patients with alcohol intoxication presented with significantly higher short-term mortality (OR: 3.0, 95% CI 2.0 to 4.4; p<0.001) than patients without alcohol intoxication. However, on comparison with propensity score-matched patients with respect to sex, age, comorbidity, Glasgow Coma Scale (GCS), injury region based on Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), alcohol intoxication did not significantly influence mortality (OR: 0.8, 95% CI 0.5 to 1.4; p=0.563). This implied that the higher mortality of alcohol-intoxicated patients was attributable to patient characteristics such as a higher injury severity rather than alcohol intoxication. Even on comparison with sex-matched, age-matched and comorbidity-matched patients without alcohol intoxication, patients with alcohol intoxication still had significantly higher total expenditure (17.4% higher), cost of operation (40.3% higher), cost of examination (52.8% higher) and cost of pharmaceuticals (38.3% higher).



The associated higher mortality of adult trauma patients with alcohol intoxication was completely attributable to other patient characteristics and associated injury severity rather than the effects of alcohol. However, patients with alcohol intoxication incurred significantly higher expenditure than patients without alcohol intoxication, even on comparison with sex-matched, age-matched and comorbidity-matched patients without alcohol intoxication.
Executive Master Program, Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan.|Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Shu-Hui
SH
Peng
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Shiun-Yuan
SY
Hsu
Department of Plastic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Pao-Jen
PJ
Kuo
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Cheng-Shyuan
CS
Rau
Executive Master Program, Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan.
Ya-Ai
YA
Cheng
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Ching-Hua
CH
Hsieh
D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications* / Q000401:mortality*; D003430:Cross-Sectional Studies; D000431:Ethanol / Q000097:blood*; D005260:Female; D015600:Glasgow Coma Scale; D005102:Health Expenditures; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012042:Registries; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*
D000431:Ethanol
Alcohol intoxication; Cost; Length of stay; Mortality; Trauma