1. The impact of alcohol use and withdrawal on trauma outcomes: A case control study
- Author
-
Emily Huang, Marie Fleury, Marc J. Shapiro, Cheng Ng, James A. Vosswinkel, Hazim Hakmi, Brian Bronson, and Randeep S. Jawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Alcohol ,Trauma outcomes ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Mechanical ventilation ,business.industry ,Trauma center ,Case-control study ,030208 emergency & critical care medicine ,General Medicine ,Middle Aged ,medicine.disease ,Substance Withdrawal Syndrome ,Icu admission ,Hospitalization ,Alcoholism ,chemistry ,Case-Control Studies ,Alcohol withdrawal syndrome ,Emergency medicine ,Blood alcohol level measurement ,Wounds and Injuries ,Female ,Surgery ,business - Abstract
Introduction Many patients admitted to hospitals with acute trauma have positive serum blood alcohol levels. Published associations between alcohol use, injury patterns, and outcomes are inconsistent. We sought to further delineate the impact of alcohol use and alcohol withdrawal on hospital outcomes amongst acute trauma patients. Methods We performed a retrospective analysis of adult trauma patients hospitalized at a suburban level 1 trauma center between January 2015 and September 2019 with a blood alcohol level measurement and/or classification as alcohol withdrawal syndrome (AWS). Patients were separated into three groups: BAL ≤10 mg/dL, BAL >10 mg/dL, and alcohol withdrawal syndrome (AWS). Results Overall, 3896 patients met study criteria with 75.6% BAL ≤10, 23.2% BAL >10, and 1.2% AWS. The median age was significantly different (BAL ≤ 10: 59 years, BAL > 10: 44 years, AWS: 53.5 years). Alcohol withdrawal was experienced by patients with BAL ≤10 and BAL >10. While injury severity and mortality were similar across all 3 groups, AWS patients experienced significantly longer hospital and ICU lengths of stay, unplanned ICU admission, need for mechanical ventilation, and higher rates of complications. Patients with AWS had high rates of acute neuropsychiatric symptoms, complicating their management. Conclusions Except for mortality, AWS patients experienced worse outcomes. The complex nature of alcohol withdrawal cases, including the possibility of developing AWS despite a negative BAL on admission, emphasizes the need for early assessment for alcohol withdrawal risk factors and input from specialists.
- Published
- 2021