Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion

중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구

  • Jung, Ho Hyung (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Han, Sang Kyoon (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Lee, Sung Wha (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Park, Sung Wook (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Park, Soon Chang (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Yeom, Seok Ran (Department of Emergency Medicine, Pusan National University Hospital) ;
  • Min, Moon Gi (Department of Emergency Medicine, Pusan National University Yangsan Hospital) ;
  • Kim, Yong In (Department of Emergency Medicine, Pusan National University Yangsan Hospital) ;
  • Ryu, Ji Ho (Department of Emergency Medicine, Pusan National University Yangsan Hospital)
  • 정호형 (부산대학교병원 응급의학과) ;
  • 한상균 (부산대학교병원 응급의학과) ;
  • 이성화 (부산대학교병원 응급의학과) ;
  • 박성욱 (부산대학교병원 응급의학과) ;
  • 박순창 (부산대학교병원 응급의학과) ;
  • 염석란 (부산대학교병원 응급의학과) ;
  • 민문기 (양산부산대학교병원 응급의학과) ;
  • 김용인 (양산부산대학교병원 응급의학과) ;
  • 류지호 (양산부산대학교병원 응급의학과)
  • Received : 2014.06.24
  • Accepted : 2014.09.12
  • Published : 2014.12.31
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Abstract

Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.

Keywords

References

  1. Scheyerer MJ, Dutschler J, Billeter A, Zimmermann SM, Sprengel K, Werner CM, et al. Effect of elevated serum alcohol level on the outcome of severely injured patients. Emerg Med J 2013; 0: 1-5.
  2. Available at: http://kostat.go.kr assessed June 16, 2014.
  3. Borges G, Cherpitel C, Mittleman M. Risk of injury after alcohol consumption: a case-crossover study in the emergency department. Soc Sci Med 2004; 58: 1191-200. https://doi.org/10.1016/S0277-9536(03)00290-9
  4. Tulloh BR, Collopy BT. Positive correlation between blood alcohol level and ISS in road trauma. Injury 1994; 25: 539-43. https://doi.org/10.1016/0020-1383(94)90097-3
  5. Available at: http://www.index.go.kr/potal/govindic/ userPageCh.do assessed June 16, 2014.
  6. World Health Organization. Department of Mental Health and Substance Dependence, International Guide for Monitoring Alcohol Consumption and Related Harm. 2000.
  7. Hadjizacharia P, O'Keeffe T, Plurad DS, Green DJ, Brown CV, Chan LS, et al. Alcohol exposure and outcomes in trauma patients. Eur J Trauma Emerg Surg 2011; 37: 169-75. https://doi.org/10.1007/s00068-010-0038-5
  8. Mann B, Desapriya E, Fujiwara T, Pike I. Is blood alcohol level a good predictor for injury severity outcomes in motor vehicle crash vicitims? Emerg Med Int 2011; 2011: 1-6.
  9. World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. 2009.
  10. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol- use disorder. Lancet 2009; 373: 2223-33. https://doi.org/10.1016/S0140-6736(09)60746-7
  11. Available at: http://kostat.go.kr assessed June 16, 2014.
  12. Cherpitel CJ. Alcohol and injuries: a review of international emergency room studies since 1995. Drug Alcohol Rev 2007; 262: 201-14.
  13. MacLeod JB, Hungerford DW. Alcohol-related injury visits: Do we know the true prevalence in U.S. trauma centres? Injury 2011; 42: 922-6. https://doi.org/10.1016/j.injury.2010.01.098
  14. Demetriades D, Gkiokas G, Velmahos GC, Brown C, Murray J, Noguchi T. Alcohol and illicit drugs in traumatic deaths: prevalence and association with type and severity of injuries. J Am Coll Surg 2004; 199: 687-92. https://doi.org/10.1016/j.jamcollsurg.2004.07.017
  15. Choi YH, Kim GB, Lee DH, Eo EK, Jung KY, Kim JS, et al. Effect of Alcohol Ingestion on the Severity and Outcome in Trauma Patients. J Korean Soc Emerg Med 2006; 17: 231-7.
  16. Cornwell EE, Belzberg H, Velmahos G, Chan LS, Demetriades D, Stewart BM, et al. The prevalence and effect of alcohol and drug abuse on cohort-matched critically injured patients. Am Surg 1998; 64: 461-5.
  17. Plurad D, Demetriades D, Gruzinski G, Preston C, Chan L, Gaspard D, et al. Pedestrian Injuries: The Association of Alcohol Consumption with the Type and Severity of Injuries and Outcomes. J Am Coll Surg 2006; 202: 919-27. https://doi.org/10.1016/j.jamcollsurg.2006.02.024
  18. World Health Organization. global status report on alcohol and health. 2011.
  19. Available at: http://www.koroad.or.kr/kp_web/accStatReport. do assessed June 16, 2014.
  20. Marx JA, Hockberger RS, Walls RM. Rosen' Emergency Medicine. Concepts and clinical practice. 7th ed. Philadelphia: Mosby; 2010: 2390.
  21. Shih HC, Hu SC, Yang CC, Ko TJ, Wu JK, Lee CH. Alcohol intoxication increases morbidity in drivers involved in motor vehicle accidents. Am J Emerg Med 2003; 21: 91-4. https://doi.org/10.1053/ajem.2003.50025
  22. Marx J. Alcohol and trauma. Emerg Med Clin North Am 1990; 8: 929-38.
  23. Marx JA, Hockberger RS, Walls RM. Rosen' Emergency Medicine. Concepts and clinical practice. 7th ed. Philadelphia: Mosby; 2010: 2376.
  24. Hsieh CH, Su LT, Wang YC, Fu CY, Lo HC, Lin CH. Does Alcohol Intoxication Protect Patients from Severe Injury and Reduce Hospital Mortality? The Association of Alcohol Consumption with the Severity of Injury and Survival in Trauma Patients. Am Surg 2013; 79: 1289-94.
  25. Stuke L, Diaz-Arrastia R, Gentilello LM, Shafi S. Effect of Alcohol on Glasgow Coma Scale in Head-Injured Patients. Ann Surg 2007; 245: 651-5. https://doi.org/10.1097/01.sla.0000250413.41265.d3
  26. Zeckey C, Dannecker S, Hildebrand F, Mommsen P, Scherer R, Probst C, et al. Alcohol and multiple trauma: is there an influence on the outcome? Alcohol 2011; 45: 245-51. https://doi.org/10.1016/j.alcohol.2010.08.004
  27. Tureci E, Dashti R, Tanriverdi T, Sanus GZ, Oz B, Uzan M. Acute ethanol intoxication in a model of traumatic brain injury: the protective role of moderate doses demonstrated by immunoreactivity of synaptophysin in hippocampal neurons. Neurol Res 2004; 26: 108-12. https://doi.org/10.1179/016164104773026633
  28. Woolf PD, Cox C, Kelly M, McDonald JV, Hamill RW. Alcohol intoxication blunts sympatho-adrenal activation following brain injury. Alcohol Clin Exp Res 1990; 14: 205-9. https://doi.org/10.1111/j.1530-0277.1990.tb00473.x
  29. Daughters K, Waxman K, Greenway S, Aswani S, Cinat M, Scannell G, et al. Ethanol added to resuscitation improves survival in an experimental model of hemorrhagic shock. Am Surg 1995; 61: 896-903.
  30. Cherpitel CJ, Bond J, Ye Y, Borges G, Macdonald S, Giesbrecht N. A cross-national meta-analysis of alcohol and injury: data from the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP).Addiction 2003; 98: 1277-86. https://doi.org/10.1046/j.1360-0443.2003.00459.x
  31. Jurkovich GJ, Rivara FP, Gurney JG, Fligner C, Ries R, Mueller BA, et al. The effect of acute alcohol intoxication and chronic alcohol abuse on outcome from trauma. JAMA 1993; 270: 51-6. https://doi.org/10.1001/jama.1993.03510010057029