McKinzie Brian P, Worrall Cathy L, Simpson Kit N, Couillard Deborah J, Leon Stuart M
South Carolina College of Pharmacy Residency Program, Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Am Surg. 2010 May;76(5):492-6.
Chronic alcohol consumption has been linked to increased morbidity and mortality in the intensive care unit setting. The purpose of our study was to assess outcomes in trauma patients admitted to our institutional university-affiliated, Level I emergency trauma unit (ETU) with and without per cent carbohydrate-deficient transferrin (%CDT) elevations over a 12-week timeframe. Markers for alcohol consumption including %CDT, gamma glutamyl transferase, and serum osmolality were measured along with the standard trauma laboratory panel on arrival to the ETU. Intensive care unit length of stay (LOS), length of time requiring ventilator support, hospital LOS, total hospital charges as well as incidences of postoperative complications were collected on all patients with a LOS greater than or equal to 48 hours. Demographics between the groups were similar. Drinking histories were more significant in the elevated %CDT group (P = 0.0006). Patients with elevated %CDT had significantly longer ICU and hospital LOS (5.1 vs. 3.9, P = 0.01; 8.7 vs. 7.1 days, P = 0.0052) and ventilator days (2 vs. 1.5 days, P = 0.0286). Complications and hospital charges were similar between groups. Trauma patients presenting to the ETU with %CDT elevations appear to be at risk for longer ICU and hospital LOS.
长期饮酒与重症监护病房环境中发病率和死亡率的增加有关。我们研究的目的是评估在12周时间内,入住我们机构大学附属一级急诊创伤单元(ETU)的创伤患者,无论其碳水化合物缺乏转铁蛋白百分比(%CDT)是否升高的预后情况。在患者抵达ETU时,除了检测标准创伤实验室指标外,还测量了包括%CDT、γ-谷氨酰转移酶和血清渗透压在内的饮酒标志物。收集了所有住院时间大于或等于48小时患者的重症监护病房住院时间(LOS)、需要呼吸机支持的时间长度、医院住院时间、医院总费用以及术后并发症的发生率。两组之间的人口统计学特征相似。%CDT升高组的饮酒史更为显著(P = 0.0006)。%CDT升高的患者的重症监护病房和医院住院时间显著更长(分别为5.1天对3.9天,P = 0.01;8.7天对7.1天,P = 0.0052),呼吸机使用天数也更长(2天对1.5天,P = 0.0286)。两组之间的并发症和医院费用相似。%CDT升高的ETU创伤患者似乎有更长的重症监护病房和医院住院时间的风险。