Department of Emergency Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA.
Am J Emerg Med. 2013 Apr;31(4):705-9. doi: 10.1016/j.ajem.2012.12.032. Epub 2013 Feb 4.
The purpose was to determine the proportion of alcohol-positive (AlcPos) trauma patients in different age groups and any association with mortality using the National Trauma Data Bank.
Several variables were extracted from the National Trauma Data Bank (version 6.2) using MS Access 2007: age, alcohol presence, Injury Severity Score (ISS), and discharge status (alive vs dead). Age groups for logistic regression were arbitrarily defined as follows: 0 to 10, 11 to 20, 21 to 39, 40 to 64, and older than 64 years.
Approximately 47% of all trauma survivors were tested for alcohol (621,174 of a total of 1,311,137), and 28% of those were AlcPos (176,107/621,174). The proportion of AlcPos patients gradually increased to maximum at 22 years, when 46% (6797/14,732) tested were AlcPos. The proportion AlcPos gradually declined to 35% by age 50 years, then to 15% (2516/16,244) by age 66 to 70 years. The ISSs were significantly higher in AlcPos patients in all age groups (P < .01). Mortality rates were higher in AlcPos children (up to age 20 years) and in adults older than 40 years. The AlcPos patients who were 21 to 39 years old had lower mortality compared with alcohol-negative patients. Logistic regression analysis (controlling for ISSs) revealed that being AlcPos did not play a role in mortality until age 21 to 39 years (AlcPos lower mortality) and in age 40 to 64 years and older than 65 years (AlcPos higher mortality).
Trauma patients of all ages may be AlcPos. Being AlcPos is a marker for greater injury in all age groups. After controlling for ISSs, trauma patients 40 years and older who were AlcPos have increased mortality. This study suggests a role for alcohol testing in all age groups.
本研究旨在通过国家创伤数据库（NTDB）确定不同年龄组酒精阳性（AlcPos）创伤患者的比例，以及其与死亡率的关系。
使用 MS Access 2007 从 NTDB（版本 6.2）中提取了几个变量：年龄、酒精存在情况、损伤严重程度评分（ISS）和出院状态（存活或死亡）。逻辑回归的年龄组定义为：0 至 10 岁、11 至 20 岁、21 至 39 岁、40 至 64 岁和 65 岁以上。
大约 47%的创伤幸存者接受了酒精检测（1311137 例中的 621174 例），其中 28%为 AlcPos（621174 例中的 176107 例）。AlcPos 患者的比例逐渐增加，在 22 岁时达到最大值，为 46%（14732 例中的 6797 例）。AlcPos 患者的比例逐渐下降到 50 岁时的 35%，然后下降到 66 至 70 岁时的 15%（16244 例中的 2516 例）。在所有年龄组中，AlcPos 患者的 ISS 明显更高（P <.01）。AlcPos 儿童（0 至 20 岁）和 40 岁以上成年人的死亡率较高。21 至 39 岁 AlcPos 患者的死亡率低于酒精阴性患者。逻辑回归分析（控制 ISSs）显示，AlcPos 直到 21 至 39 岁（AlcPos 降低死亡率）、40 至 64 岁和 65 岁以上（AlcPos 增加死亡率）才与死亡率无关。
各个年龄段的创伤患者都可能是 AlcPos。在所有年龄组中，AlcPos 是受伤更严重的标志。在控制 ISSs 后，40 岁及以上 AlcPos 创伤患者的死亡率增加。本研究表明，所有年龄段的患者都应进行酒精检测。
