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Patient mortality following alcohol use and trauma: a propensity-matched analysis

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Objective

To examine the outcomes of trauma patients who tested positive for alcohol at the time of hospital arrival versus those who tested negative.

Methods

Data were pulled from the National Trauma Data Bank (2007–2010). All injured patients who were ≥14 years of age, sustained a “blunt” or “penetrating” injury, had complete systolic blood pressure (SBP) and heart rate (HR) records, were taken to a level 1 or 2 trauma center, and who received a confirmed blood alcohol test were included in the study. Any blood alcohol concentration (BAC) above the legal limit (≥0.08 g/dL) was considered “positive” for alcohol, and if no alcohol was identified it was considered “negative”. Patients’ demography and clinical information were compared across groups using Chi-square and Wilcoxon rank sum tests. Logistic regression, propensity score matching, and a follow-up paired analysis were also performed.

Results

Of 279,460 total patients, around one-third of the patients (92,960) tested positive for BAC. There were clear demographic differences found between the two groups regarding age, gender, race, and injury type. There was also a significantly higher mortality rate (4.3 vs. 3.1%, P < 0.001) and a longer hospital length of stay (4 vs. 3 days, P < 0.001) found in the alcohol-negative group. Propensity score matching was also performed resulting in 92,959 patients per group. Using the paired data, the overall mortality observed was 3.1 vs. 3.3% (P = 0.035) between the alcohol-positive and alcohol-negative groups, respectively. There was no significant difference noted in the total hospital length of stay (median: 3 vs. 4 days, P = 0.84).

Conclusion

Patients who tested positive for alcohol following a traumatic injury showed no clinically significant reduction in mortality and no significant difference in total hospital length of stay.

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Author information

Authors and Affiliations

  1. Department of Surgery, Jersey Shore University Medical Center, Neptune, NJ, USA

    N. Ahmed

  2. Office of Research Administration, Jersey Shore University Medical Center, Neptune, NJ, USA

    P. Greenberg

Authors
  1. N. Ahmed
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  2. P. Greenberg
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Corresponding author

Correspondence to N. Ahmed.

Ethics declarations

All procedures followed were in accordance with the ethical standards of the Institutional Review Board of Meridian Health and with the Helsinki Declaration of 1975, as revised in 2008. Since the study was done using a de-identified National database from the American College of Surgeons that is available to all researchers, this study was exempted from IRB review as per policy.

Conflict of interest

The authors (Nasim Ahmed and Patricia Greenberg) declare that they have no conflicts of interest.

Informed consent

Given that this study was done using a de-identified National database from the American College of Surgeons that is available to all researchers, this study was exempted from IRB review as per policy and no informed consent was required.

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Ahmed, N., Greenberg, P. Patient mortality following alcohol use and trauma: a propensity-matched analysis. Eur J Trauma Emerg Surg 45, 151–158 (2019). https://doi.org/10.1007/s00068-017-0794-6

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  • DOI: https://doi.org/10.1007/s00068-017-0794-6

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