Rau Cheng-Shyuan, Liu Hang-Tsung, Hsu Shiun-Yuan, Cho Tzu-Yu, Hsieh Ching-Hua
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
BMJ Open. 2014 Oct 31;4(10):e005947. doi: 10.1136/bmjopen-2014-005947.
To provide an overview of the demographic characteristics of patients with positive blood alcohol concentration (BAC) and to investigate the performance of brain CT scans in these patients.
Cross-sectional study.
Taiwan.
2192 patients who had undergone a test for blood alcohol of 13,233 patients registered in the Trauma Registry System between 1 January 2009 and 31 December 2012. A BAC level of 50 mg/dL was defined as the cut-off value. Detailed information was retrieved from the patients with positive BAC (n=793) and was compared with information from those with a negative BAC (n=1399).
Glasgow Coma Scale (GCS) and Injury Severity Score (ISS) as well as the performance and findings of obtained brain CT scans.
Patients with positive BAC had a higher rate of face injury, but a lower GCS score, a lower rate of head and neck injury, a lower ISS and New Injury Severity Score. Alcohol use was associated with a shorter length of hospital stay (8.6 vs 11.4 days, p=0.000) in patients with an ISS of <16. Of 496 patients with positive BAC who underwent brain CT, 164 (33.1%) showed positive findings on CT scan. In contrast, of 891 patients with negative BAC who underwent brain CT, 389 (43.7%) had positive findings on CT scan. The lower percentage of positive CT scan findings in patients with positive BAC was particularly evident in patients with an ISS <16 (18.0% vs 28.8%, p=0.001).
Patients who consumed alcohol tended to have a low GCS score and injuries that were less severe. However, given the significantly low percentage of positive findings, brain CT might be overused in these patients with less severe injuries.
概述血液酒精浓度(BAC)呈阳性的患者的人口统计学特征,并研究这些患者脑部CT扫描的表现。
横断面研究。
台湾。
2009年1月1日至2012年12月31日期间在创伤登记系统登记的13233名接受血液酒精检测的患者中的2192例。将BAC水平50mg/dL定义为临界值。从BAC呈阳性的患者(n = 793)中检索详细信息,并与BAC呈阴性的患者(n = 1399)的信息进行比较。
格拉斯哥昏迷量表(GCS)、损伤严重度评分(ISS)以及所获得的脑部CT扫描的表现和结果。
BAC呈阳性的患者面部损伤发生率较高,但GCS评分较低,头颈部损伤发生率较低,ISS和新损伤严重度评分较低。在ISS<16的患者中,饮酒与住院时间较短相关(8.6天对11.4天,p = 0.000)。在496例接受脑部CT检查的BAC呈阳性的患者中,164例(33.1%)CT扫描结果呈阳性。相比之下,在891例接受脑部CT检查的BAC呈阴性的患者中,389例(43.7%)CT扫描结果呈阳性。BAC呈阳性的患者CT扫描阳性结果的百分比较低在ISS<16的患者中尤为明显(18.0%对28.8%,p = 0.001)。
饮酒的患者往往GCS评分较低且损伤不太严重。然而,鉴于阳性结果的比例显著较低,脑部CT在这些损伤不太严重的患者中可能被过度使用。