@article{ref1,
title="Effect of elevated serum alcohol level on the outcome of severely injured patients",
journal="Emergency medicine journal",
year="2013",
author="Scheyerer, Max J. and Dütschler, Joel and Billeter, Adrian and Zimmermann, Stefan M. and Sprengel, Kai and Werner, Clément M. L. and Simmen, Hans-Peter and Wanner, Guido A.",
volume="31",
number="10",
pages="813-817",
abstract="BACKGROUND: The influence of high blood alcohol level (BAL) on the outcome of severely injured patients and the corresponding pathophysiological changes is a controversial issue. OBJECTIVE: To carry out a prognostic study to compare the physiological values and short-term outcome of severely injured patients depending on their serum alcohol level. METHODS: A total of 383 severely injured patients with an Injury Severity Score (ISS) ≥17 were admitted to the trauma division between October 2008 and December 2009 and enrolled into this study. Patients were grouped according to their BAL (>0.5‰,'BAL positive' vs <0.5‰,'BAL negative'). Trauma mechanism, pattern of injury and its treatment, and a course of intensive care treatment, physiological parameters and outcome with respect to mortality were analysed. RESULTS: Both groups had similar ISS. In comparison with the BAL-negative group, patients in the BAL-positive group had a significantly lower Glasgow Coma Scale score (9.64 vs 12 points; p=0.005) and, although not significant, a trend towards higher values of the Abbreviated Injury Score for the head (3.29 vs 2.81 points; p=0.146). Furthermore, significantly higher lactate (3.11 mmol/L vs 2.02 mmol/L; p<0.001) levels and lower median arterial pressure values (87.9 mm Hg vs 99.4 mm Hg; p=0.006) were seen in the BAL-positive group at day of admission. However, the overall in-hospital mortality was comparable to that in BAL-negative patients (19.6% vs 21.5%). Similarly, hospital stay (15.29 vs 17.55 days) and duration of intensive care unit treatment (8.53 vs 8.36 days) were not significantly affected by a high BAL upon admission. CONCLUSIONS: Severely injured patients with a raised BAL have a higher incidence of severe traumatic brain injury and worse initial physiological parameters. However, the survival rate and in-hospital stay is not influenced. This supports the theory of a neuroprotective role of alcohol.<p /> <p>Language: en</p>",
language="en",
issn="1472-0205",
doi="10.1136/emermed-2013-202804",
url="http://dx.doi.org/10.1136/emermed-2013-202804"
}