scholarly journals The Relationship Between Blood Alcohol Concentration and Injury Severity in Patients Admitted to The Hospital Emergency Department After a Motor Vehicle Accident

2016 ◽  
Vol 15 (3) ◽  
pp. 121-125
Author(s):  
Serkan Dogan ◽  
Nurdan Acar ◽  
Arif Alper Cevik ◽  
Engin Ozakin ◽  
Filiz Baloglu Kaya ◽  
...  
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Hospital Emergency Department ◽  
Blood Alcohol ◽  
Hospital Emergency ◽  
Vehicle Accident ◽  
The Relationship

Does Level of Blood Alcohol Content Affect Clinical Outcomes After Trauma in Older Adult Patients?

2020 ◽  
Vol 86 (9) ◽  
pp. 1106-1112
Author(s):  
Mary K. Bryant ◽  
Katherine Reynolds ◽  
Connor Brittain ◽  
Zachery Patel ◽  
Trista D.S. Reid ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Older Patients ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Trauma Patients ◽  
Blood Alcohol ◽  
Matched Cohort ◽  
Poor Outcomes

Introduction Preinjury alcohol use and older age have independently been associated with poor outcomes. This study examined whether higher levels of blood alcohol concentration (BAC) correlated with an increased likelihood of poor outcomes in older trauma patients. Methods This was a retrospective cohort study of injured patients ≥65 years with BAC testing presenting to a Level 1 trauma center between 2015 and 2018. Patients were stratified by BAC at 4 thresholds of intoxication: BAC ≧10 mg/dL, BAC ≧80 mg/dL, BAC ≧150 mg/dL, and BAC ≧200 mg/dL. Propensity score matching using inverse probability of treatment weighting was used to estimate outcomes. Logistic and Poisson regression models were performed for each threshold of the BAC level with the matched cohort to assess clinical outcomes. Results Of all older patients (n = 3112), 32.5% (n = 1012) had BAC testing. In the matched cohort of 883 patients (76.7 ± 8.2 years; 48.1% female), 111 (12.5%) had BAC ≧10 mg/dL, 83 (74.8%) had BAC ≧80 mg/dL, 60 (54.1%) had BAC ≧150 mg/dL, and 37 (33.3%) had BAC ≧200 mg/dL. Falls (60.5%) and motor vehicle crashes (28.9%) were the most common mechanisms of injury. Median (IQR) of Injury Severity Score (ISS) was 5 (1-10). The risk of severe injury (ISS ≧15) was similar between alcohol-positive and alcohol-negative patients (9.9% vs 15.0%, P = .151). BAC ≧10 g/dL was not associated with length of stay, intensive care unit admission, or in-hospital complication, nor was any of the other 3 analyzed BAC thresholds. Conclusion Overall, any detectable BAC along and increasing thresholds of BAC was not associated with poor in-hospital outcomes of older patients after trauma. Alcohol screening was low in this population, and intoxication may bias injury assessment, leading to mistriage of older trauma patients.

scholarly journals Moderate and severe traumatic brain injury: effect of blood alcohol concentration on Glasgow Coma Scale score and relation to computed tomography findings

2015 ◽  
Vol 122 (1) ◽  
pp. 211-218 ◽  
Author(s):  
Nils Petter Rundhaug ◽  
Kent Gøran Moen ◽  
Toril Skandsen ◽  
Kari Schirmer-Mikalsen ◽  
Stine B. Lund ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Dependent Manner ◽  
Blood Alcohol ◽  
Severe Tbi ◽  
Gcs Score ◽  
Dose Dependent

OBJECT The influence of alcohol is assumed to reduce consciousness in patients with traumatic brain injury (TBI), but research findings are divergent. The aim of this investigation was to study the effects of different levels of blood alcohol concentration (BAC) on the Glasgow Coma Scale (GCS) scores in patients with moderate and severe TBI and to relate the findings to brain injury severity based on the admission CT scan. METHODS In this cohort study, 265 patients (age range 16–70 years) who were admitted to St. Olavs University Hospital with moderate and severe TBI during a 7-year period were prospectively registered. Of these, 217 patients (82%) had measured BAC. Effects of 4 BAC groups on GCS score were examined with ordinal logistic regression analyses, and the GCS scores were inverted to give an OR > 1. The Rotterdam CT score based on admission CT scan was used to adjust for brain injury severity (best score 1 and worst score 6) by stratifying patients into 2 brain injury severity groups (Rotterdam CT scores of 1–3 and 4–6). RESULTS Of all patients with measured BAC, 91% had intracranial CT findings and 43% had BAC > 0 mg/dl. The median GCS score was lower in the alcohol-positive patients (6.5, interquartile range [IQR] 4–10) than in the alcohol-negative patients (9, IQR 6–13; p < 0.01). No significant differences were found between alcohol-positive and alcohol-negative patients regarding other injury severity variables. Increasing BAC was a significant predictor of lower GCS score in a dose-dependent manner in age-adjusted analyses, with OR 2.7 (range 1.4–5.0) and 3.2 (range 1.5–6.9) for the 2 highest BAC groups (p < 0.01). Subgroup analyses showed an increasing effect of BAC group on GCS scores in patients with Rotterdam CT scores of 1–3: OR 3.1 (range 1.4–6.6) and 6.7 (range 2.7–16.7) for the 2 highest BAC groups (p < 0.01). No such relationship was found in patients with Rotterdam CT scores of 4–6 (p = 0.14–0.75). CONCLUSIONS Influence of alcohol significantly reduced the GCS score in a dose-dependent manner in patients with moderate and severe TBI and with Rotterdam CT scores of 1–3. In patients with Rotterdam CT scores of 4–6, and therefore more CT findings indicating increased intracranial pressure, the brain injury itself seemed to overrun the depressing effect of the alcohol on the CNS. This finding is in agreement with the assumption of many clinicians in the emergency situation.

Correlating the Blood Alcohol Concentration with Outcome after Traumatic Brain Injury: Too Much Is Not a Bad Thing

2011 ◽  
Vol 77 (10) ◽  
pp. 1416-1419 ◽  
Author(s):  
Cherisse Berry ◽  
Eric J. Ley ◽  
Daniel R. Margulies ◽  
James Mirocha ◽  
Marko Bukur ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Los Angeles ◽  
Linear Trend ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Multivariable Logistic Regression Analysis ◽  
Blood Alcohol ◽  
Severe Tbi ◽  
The Relationship

Although recent evidence suggests a beneficial effect of alcohol for patients with traumatic brain injury (TBI), the level of alcohol that confers the protective effect is unknown. Our objective was to investigate the relationship between admission blood alcohol concentration (BAC) and outcomes in patients with isolated moderate to severe TBI. From 2005 to 2009, the Los Angeles County Trauma Database was queried for all patients ≥14 years of age with isolated moderate to severe TBI and admission serum alcohol levels. Patients were then stratified into four levels based on admission BAC: None (0 mg/dL), low (0-100 mg/dL), moderate (100-230 mg/dL), and high (≥230 mg/dL). Demographics, patient characteristics, and outcomes were compared across levels. In evaluating 3794 patients, the mortality rate decreased with increasing BAC levels (linear trend P < 0.0001). In determining the relationship between BAC and mortality, multivariable logistic regression analysis demonstrated a high BAC level was significantly protective (adjusted odds ratio 0.55; 95% confidence interval: 0.38-0.8; P = 0.002). In the largest study to date, a high (≥230 mg/dL) admission BAC was independently associated with improved survival in patients with isolated moderate to severe TBI. Additional research is warranted to investigate the potential therapeutic implications.

scholarly journals Maxillofacial Fractures of Pedestrians Injured in a Motor Vehicle Accident

2013 ◽  
Vol 6 (1) ◽  
pp. 37-41 ◽  
Author(s):  
Kazuhiko Yamamoto ◽  
Yumiko Matsusue ◽  
Satoshi Horita ◽  
Kazuhiro Murakami ◽  
Yoshihiro Ueyama ◽  
...  
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
The Body ◽  
Facial Injury ◽  
Severity Scale ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Vehicle Accident ◽  
Maxillofacial Fractures

Maxillofacial fractures of pedestrians injured in a motor vehicle accident were retrospectively analyzed. The patients were 38 males and 26 females, and their age was distributed almost evenly from 1 to 91 years old (average 45.9 ± 24.8 years old). Motor vehicle collisions were with an automobile in 46 patients (71.9%), a motorcycle in 17 (26.6%), and a train in 1 (1.6%). The midface was involved in 32 patients (50.0%), the mandible in 19 (29.7%), and both the mandible and the midface in 13 (20.3%). Fractures were frequently observed in the zygoma and alveolus in the midface and in the condyle, symphysis, and body in the mandible. The facial injury severity scale (FISS) rating ranged from 1 to 9 (average 2.30 ± 1.79). Injuries to other sites of the body occurred in 29 patients (45.3%). Observation was most frequently chosen in 26 patients (40.6%), followed by open reduction and internal fixation (ORIF) in 18 (28.1%), and maxillomandibular fixation (MMF) in 8 (12.5%). The FISS rating was higher in patients treated with ORIF and MMF. Injuries to other sites of the body were observed at a higher rate in patients who collided with an automobile and were also treated by ORIF.

ALCOHOL LEVELS IN BODY FLUIDS AFTER INGESTION OF DISTILLED SPIRITS

1959 ◽  
Vol 37 (1) ◽  
pp. 43-52 ◽  
Author(s):  
B. B. Coldwell ◽  
H. Ward Smith
Keyword(s):  
Body Weight ◽  
Venous Blood ◽  
Blood Alcohol Concentration ◽  
Weighted Average ◽  
Alcohol Concentration ◽  
Whole Body ◽  
Blood Alcohol ◽  
Time Intervals ◽  
Distilled Spirits ◽  
The Relationship

Known volumes of 70-proof distilled spirits were fed to 68 volunteers, making a total of 141 separate doses. The amount of alcohol appearing in the venous blood, saliva, and urine at various time intervals after ingestion was determined by a modified Widmark method, and in the breath by the Breathalyzer. The relationship between time after ingestion, venous blood alcohol concentration (VBA), and Breathalyzer reading (BR) was as follows:(1) between 0.5 and 2.5 hours after ingestion, VBA = (BR + 0.048) ± 0.124 mg/ml;(2) between 30 to 40 minutes after ingestion, VBA = (BR − 0.071) ± 0.065 mg/ml;(3) between 2 to 2.5 hours after ingestion, VBA = (BR + 0.102) ± 0.117 mg/ml. The weighted average ratios of saliva and urine alcohols to venous blood alcohol were 1.12:1 and 1.24:1, respectively. The standard error of estimating the venous blood alcohol indirectly from the saliva alcohol was ±0.075 mg/ml, and from urine alcohol ±0.081 mg/ml when the samples were obtained from 0.5 to 2.5 and from 0.75 to 2.5 hours after drinking, respectively. Over the range of concentrations studied alcohol disappeared from the venous blood at the rate of 0.13 ±0.05 mg/ml/hr and the quantity eliminated from the whole body, per 100 lb of body weight per hour, approximated 0.4 fl. oz of 70-proof distilled spirits.

scholarly journals Homeless people under the influence of alcohol admitted to hospital emergency departments in Poland

2020 ◽  
Vol 37 (2) ◽  
pp. 190-200
Author(s):  
Anna Burak ◽  
Katarzyna Cierzniakowska ◽  
Aleksandra Popow
Keyword(s):  
Alcohol Use ◽  
Emergency Departments ◽  
Average Length ◽  
Blood Alcohol Concentration ◽  
Homeless People ◽  
Medical Personnel ◽  
Alcohol Concentration ◽  
Blood Alcohol ◽  
Hospital Emergency ◽  
Hospital Emergency Departments

Aim: To assess the incidence of diagnoses related to alcohol use in the population of homeless people admitted to hospital emergency departments (EDs). Material and method: Data were analysed from three hospitals concerning stays of homeless people in three EDs in Bydgoszcz, Poland, in 2013–2015; 3133 stays were identified. The data were compiled using Microsoft Excel and Statistica 10 statistical software. Results: At the time of admission to EDs, 31% of homeless people were considered to be under the influence of alcohol. Diagnoses related to alcohol use accounted for 25% of all diagnoses. The average blood alcohol concentration in the patients was 2.97 per mille. The average blood alcohol concentration in the group of men was significantly higher than that in the group of women ( p = 0.015). The average length of stay in the ED of patients under the influence of alcohol was significantly longer ( p < 0.0001) than among sober patients. Conclusions: Homeless people under the influence of alcohol account for a third of the population of homeless patients admitted to hospital emergency departments, while alcohol-related ICD-10 diagnoses account for a fourth of all diagnoses in these patients. Homeless patients under the influence of alcohol stay longer in hospital emergency departments than do sober homeless people, which may translate into more frequent acts of aggression towards medical personnel. In Poland there are no systemic ED-level solutions as regards dealing with homeless patients for whom alcohol dependence is in many cases a reality.

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