C. Valdez1, C. Renne1, M. Radomski1, R. Amdur1, J. Dunne1, B. Sarani1 1George Washington University School Of Medicine And Health Sciences,General Surgery,Washington, DC, USA
Introduction:
The impact of inebriation on severity of injury is unclear. Conventional teaching suggests increasing blood alcohol level (BAL) may be associated with fewer injuries because the patient is limp due to intoxication at the time of injury. The few studies to date on this topic are limited to a particular mechanism of injury (MOI), injury pattern, or BAL. Therefore we sought to determine the impact of BAL on injury pattern and severity across all MOI. We hypothesize that there is no relationship between BAL and injury severity when controlling for MOI.
Methods:
Following IRB approval, a retrospective study was performed at an adult trauma center from January 1, 2011 to December 31, 2012. All MOI were included. Injury severity was assessed using the injury severity score (ISS). Chi square and ANOVA were used to examine the relationship between BAC, injury pattern, and ISS within each MOI. Multivariate regression model (MVR) examined the BAC-ISS association adjusting for MOI, gender, and age.
Results:
Of 1397 patients, the mean age was 44±19, mean ISS was 7.5±6.8, mean BAL was 92±130 mg/dL and 70% were male. Overall mortality rate was 1.3%. Rib fracture (p=0.002) and hemo/pneumothorax (p=0.0009) were negatively associated with BAL, while concussion and laceration had a positive association with BAL (p<0.0001). An increasing BAL had a negative correlation with ISS following fall from standing (p<0.001). Across all MOI combinde, there was no significant association between BAL and ISS.
Conclusion:
Inebriated patients have a decreased risk of rib fractures and hemo/pneumothoax, and an increased risk of concussion or laceration. Increased BAL is associated with a lower ISS in the specific MOI of fall from standing. However, across all MOI, there was no significant association between BAL and ISS when controlling for MOI. Inebriated patients should be triaged and approached with the same clinical index of suspicion for injury as sober patients.
