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Correlation Between the Osmolar Gap and Serum Ethanol Level and the Accuracy of Estimated Ethanol Level in Trauma Patients and Non-Trauma Patients  

Chang, Hyung Woo (Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Sim, Min Seob (Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Han, Sang Kuk (Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Song, Hyoung Gon (Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Journal of Trauma and Injury / v.22, no.2, 2009 , pp. 148-153 More about this Journal
Abstract
Purpose: The osmolar gap increases in proportion to the ethanol level. Some previous studies have shown that the correlation between the osmolar gap and the ethanol level is weak in trauma patient by using an indirect comparison with other patients. We conducted a direct comparison of the correlation of the osmolar gap to the ethanol level between trauma patients and non-trauma patients. We also analyzed the accuracy of the estimated ethanol level between the two groups. Methods: The research candidates were adult patients who had visited the emergency department of our hospital from December 2003 to November 2008. By using a retrospective chart review, we classified them into three subgroups: non-trauma without shock, trauma without shock, and trauma with shock. In each group, we compared the correlation between the osmolar gap and the measured ethanol level, and we analyzed the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient. Results: Four hundred forty-seven patients were enrolled in this study. For correlation of the osmolar gap and the measured ethanol level, Pearson's correlation coefficient was 0.916 in all patients, 0.939 in non-trauma without shock patients, 0.917 in trauma without shock patients, and 0.844 in trauma with shock patients. In the analysis of the accuracy of the estimated ethanol level by using Lin's concordance correlation coefficient, the accuracy in trauma with shock patients was lower than that in non-trauma without shock patients. Conclusion: We found that the correlation between the osmolar gap and the measured ethanol level in the patient group with trauma was lower than it was in the patient group without trauma. Moreover trauma patients with shock had a lower accuracy of the estimated ethanol level than non-trauma patients.
Keywords
Ethanol; Osmolality; Trauma; Shock;
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