Department of Pathological Anatomy and Forensic Medicine, University of Tartu, Biomedicum, Ravila 19, Tartu, Estonia.
Alcohol Alcohol. 2013 Jul-Aug;48(4):390-5. doi: 10.1093/alcalc/agt036. Epub 2013 Apr 30.
To describe clinical, mental and physical signs in children with different severity acute alcohol intoxication (AAI) determined either by serum alcohol concentration (SAC) or by blood alcohol concentration (BAC) to study the diagnostic performance characteristics of clinical assessment and to establish the ratio of SAC:BAC in children.
Data were analysed from 256 children aged 8.4-17.9 years who were hospitalized at Estonia's two children's hospitals over a 3-year period. In each case, the on-call paediatrician completed a special form about the clinical, mental (consciousness, balance and speech) and physical (muscle tone, blood pressure, pulse and body temperature) signs of AAI. Blood samples were drawn for measurements of SAC and BAC. Diagnostic performance characteristics (sensitivity, specificity, efficiency) of the clinical assessments and the SAC:BAC ratio were calculated.
The most correctly described signs in children in different SAC groups were consciousness (rs = 0.16) and speech (rs = 0.13) (P < 0.0001). The severity of alteration of consciousness and degrees of disturbance in balance and speech were positively correlated with SAC (P < 0.001). The clinical judgment matched better with AAI determined by SAC rather than by BAC with the mean efficiency. The mean ratio between SAC and BAC was 1.19 ± 0.13 (P < 0.001) in children.
The level of consciousness is the leading sign in the clinical evaluation of children with AAI and correlates well with SAC. The severity of AAI judged by clinical assessment matched better with AAI severity stages determined by SAC than by BAC. For legal cases where BAC is required, the SAC:BAC ratio of 1.19:1 should be used in children regardless of their gender or age.
通过血清酒精浓度（SAC）或血液酒精浓度（BAC）来描述不同严重程度急性酒精中毒（AAI）儿童的临床、精神和身体体征，研究临床评估的诊断性能特征，并确定儿童 SAC：BAC 的比值。
对 256 名年龄在 8.4-17.9 岁的儿童进行了分析，这些儿童在爱沙尼亚的两家儿童医院住院治疗，时间为 3 年。在每种情况下，值班儿科医生都会填写一份关于 AAI 的临床、精神（意识、平衡和言语）和身体（肌肉张力、血压、脉搏和体温）体征的特殊表格。抽取血样测量 SAC 和 BAC。计算了临床评估和 SAC：BAC 比值的诊断性能特征（敏感性、特异性、效率）。
在不同 SAC 组的儿童中，描述最正确的体征是意识（rs = 0.16）和言语（rs = 0.13）（P < 0.0001）。意识改变的严重程度以及平衡和言语障碍的程度与 SAC 呈正相关（P < 0.001）。临床判断与 SAC 确定的 AAI 更吻合，而不是 BAC 确定的 AAI，平均效率更高。儿童 SAC 和 BAC 的平均比值为 1.19 ± 0.13（P < 0.001）。
意识水平是儿童 AAI 临床评估的主导标志，与 SAC 密切相关。临床评估判断的 AAI 严重程度与 SAC 确定的 AAI 严重程度阶段更吻合，而不是 BAC 确定的 AAI 严重程度阶段。对于需要 BAC 的法律案件，无论儿童的性别或年龄如何，都应使用 1.19:1 的 SAC：BAC 比值。
