Ahmed Nasim, Greenberg Patricia
Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, Neptune, NJ, USA.
Department of Research Administration, Jersey Shore University Medical Center, Neptune, NJ, USA.
Injury. 2019 Jan;50(1):33-38. doi: 10.1016/j.injury.2018.09.022. Epub 2018 Sep 11.
The purpose of this study was to compare the outcomes of trauma patients who were injured in a motor vehicle crash and tested positive for alcohol upon hospital arrival versus those who tested negative.
Study data came from the US National Trauma Data Bank (2007-2010). Any blood alcohol concentration (BAC) found at or above the legal limit (≥0.08 g/dL) was considered "alcohol positive", and if no alcohol was identified through testing, the patient was considered "alcohol negative". Patients' demographics including age > = 14, race, gender, drug test results, systolic blood pressure, heart rate, injury severity score (ISS), and Glasgow Coma Scale (GCS) were included in the study. Propensity score and exact pair matching were performed between the groups using baseline characteristics.
From a total of 88,794 patients, 30.9% tested positive and 69.1% tested negative for alcohol. There were significant differences found between the groups regarding age, gender, race, and GCS (all p < 0.001) as well as a significantly higher in-hospital mortality rate (3.5% vs. 2.7%, p < 0.001) and median time to patient expiration (4 vs. 3 days, p < 0.001) in the alcohol negative group. After running both matching scenarios, there was no evidence of a significant difference seen in the rates of in-hospital mortality or the median time to patient expiration between the alcohol groups in either matched comparison.
Patients who tested positive for alcohol following a traumatic motor vehicle crash showed no significant increase in in-hospital mortality or time to expiration when compared to propensity score and exact matched patients who tested negative for alcohol.
本研究的目的是比较在机动车碰撞事故中受伤且入院时酒精检测呈阳性的创伤患者与检测呈阴性的患者的治疗结果。
研究数据来自美国国家创伤数据库(2007 - 2010年)。任何血液酒精浓度(BAC)达到或高于法定限度(≥0.08 g/dL)被视为“酒精阳性”,如果通过检测未发现酒精,则患者被视为“酒精阴性”。纳入研究的患者人口统计学特征包括年龄≥14岁、种族、性别、药物检测结果、收缩压、心率、损伤严重程度评分(ISS)和格拉斯哥昏迷量表(GCS)。使用基线特征在两组之间进行倾向得分和精确配对匹配。
在总共88,794名患者中,30.9%的患者酒精检测呈阳性,69.1%呈阴性。两组在年龄、性别、种族和GCS方面存在显著差异(均p < 0.001),酒精阴性组的院内死亡率显著更高(3.5%对2.7%,p < 0.001),患者死亡的中位时间也显著更长(4天对3天,p < 0.001)。在运行两种匹配方案后,在任何一种匹配比较中,酒精组之间的院内死亡率或患者死亡中位时间均未发现显著差异。
与倾向得分匹配和精确匹配的酒精检测呈阴性的患者相比,在创伤性机动车碰撞事故后酒精检测呈阳性的患者在院内死亡率或死亡时间方面没有显著增加。