Plurad David, Demetriades Demetrios, Gruzinski Ginger, Preston Christy, Chan Linda, Gaspard Donald, Margulies Daniel, Cryer H Gill
Department of Surgery, University of Southern California, Los Angeles, CA, USA.
J Am Coll Surg. 2006 Jun;202(6):919-27. doi: 10.1016/j.jamcollsurg.2006.02.024.
Literature on the effect of alcohol ingestion on short-term outcomes for trauma patients shows conflicting results. We performed this study to investigate the prevalence of positive alcohol screens and the effect of alcohol level on injury patterns, injury severity, and outcomes in pedestrians and bicyclists involved in a collision with an automobile.
The study population included all pedestrians and bicyclists older than 10 years, treated in any of the 13 trauma centers in the Los Angeles County Emergency Services System during the calendar year 2003, who were involved in a collision with an automobile and had a blood alcohol level measured. The alcohol negative group was defined as those patients with a blood alcohol level </=0.05 g/dL. Low and high alcohol groups were defined as those having blood alcohol levels>0.05 g/dL to<0.08 g/dL and>/=0.08 g/dL, respectively. We compared the three study groups with respect to demographics, injury patterns, injury severity, complications, and outcomes. Logistic regression was used to determine if alcohol had an independent association with any outcomes.
There were 1,042 patients who met study criteria. Overall, 606 patients (58%) had a negative alcohol screen, 84 (8%) had low alcohol levels, and 352 (34%) had high alcohol levels. Alcohol level was not notably associated with severity of injury, admission hypotension, ICU length of stay, major complications, and injury pattern (head, chest, abdomen, or extremity Area Injury Score). Mortality was similar in the three alcohol level groups, but the overall complication rate and hospital length of stay were markedly higher in the high alcohol level group than they were in the negative alcohol level group.
In pedestrians and bicyclists involved in a collision with an automobile, a high alcohol level is not associated with body area severity of injury, overall severity of injury, and hospital mortality. But high alcohol level is notably associated with higher overall complication rate and longer hospital length of stay.
关于酒精摄入对创伤患者短期预后影响的文献显示结果相互矛盾。我们开展这项研究，以调查酒精筛查呈阳性的患病率，以及酒精水平对与汽车相撞的行人和骑自行车者的损伤模式、损伤严重程度及预后的影响。
研究人群包括2003年日历年期间在洛杉矶县紧急服务系统的13家创伤中心中任何一家接受治疗的所有10岁以上与汽车相撞且测量了血液酒精水平的行人和骑自行车者。酒精阴性组定义为血液酒精水平≤0.05 g/dL的患者。低酒精组和高酒精组分别定义为血液酒精水平>0.05 g/dL至<0.08 g/dL和≥0.08 g/dL的患者。我们比较了三组研究对象在人口统计学、损伤模式、损伤严重程度、并发症及预后方面的情况。采用逻辑回归分析来确定酒精是否与任何预后存在独立关联。
共有1042例患者符合研究标准。总体而言，606例患者（58%）酒精筛查呈阴性，84例（8%）酒精水平低，352例（34%）酒精水平高。酒精水平与损伤严重程度、入院时低血压、重症监护病房住院时间、主要并发症及损伤模式（头部、胸部、腹部或肢体区域损伤评分）无明显关联。三组酒精水平组的死亡率相似，但高酒精水平组的总体并发症发生率和住院时间明显高于酒精阴性组。
在与汽车相撞的行人和骑自行车者中，高酒精水平与身体区域损伤严重程度、总体损伤严重程度及医院死亡率无关。但高酒精水平与较高的总体并发症发生率和较长的住院时间明显相关。
