Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, 1945 State Route 33, Neptune 07754, NJ, USA.
Department of Research Administration, Jersey Shore University Medical Center, Neptune, NJ, USA.
Injury. 2020 Jan;51(1):91-96. doi: 10.1016/j.injury.2019.10.005. Epub 2019 Oct 4.
Motorcyclists who drink and drive are at a higher risk of death and disability than other types of drivers. The purpose of this study was to query a national trauma database to evaluate the impact of elevated blood alcohol concentration (BAC) on outcomes in patients who sustained injury following a motorcycle crash.
The National Trauma Data Bank (NTDB) data was accessed from 2012 to 2014. Patients ≥ 18 years of age who sustained a traumatic injury following a motorcycle accident with a confirmed blood alcohol test at the time of arrival to the hospital were included. Other variables examined were: sex, race, injury severity score (ISS), and initial Glasgow Coma Scale motor score (GCSMOT), systolic blood pressure (SBP, mm Hg), SBP <90, and comorbidities. Patients with a blood alcohol concentration (BAC) at or beyond the legal limit (0.08 g/dL) comprised the "alcohol positive" group, while those with a BAC confirmed negative comprised the "alcohol negative" group. The patients who tested BAC < 0.08 g/dl were excluded from the analysis. The primary outcome of the study was in-hospital mortality. Univariate followed by propensity matched analysis was performed. All p-values were 2 sided and p-values < 0.05 were considered statistically significant.
Of 113,843 patients involved in motorcycle crash, 67,183 patients underwent BAC testing. The majority (68.52%) tested negative, 21.14% tested positive above the legal limit and remaining 10.34% tested with a BAC <0.08 g/dl . A total of 29,922 patients, satisfied the inclusion criteria for final analysis. After propensity score matching, there was 100% improvement on standardized mean difference on matching variables (age, sex, race).However, differences continued between the groups on, SBP < 90, ISS and GCSMOT. The hospital mortality rates were 3.1% vs 3.9% (P < 0.001) between alcohol negative and the alcohol positive groups, respectively. The odds ratio of mortality in alcohol positive group was 1.27 (95% CI: 1.07, 1.53) and the absolute risk difference in hospital mortality was 0.008 (CI: 0.002, 0.014).
Patients who tested with a BAC above the legal limit sustained a higher injury severity score and higher in-hospital mortality compared to patients who tested negative.
与其他类型的驾驶员相比，酒后驾车的摩托车驾驶员死亡和残疾的风险更高。本研究的目的是查询国家创伤数据库，以评估在因摩托车事故受伤的患者中，血液酒精浓度（BAC）升高对结局的影响。
从 2012 年到 2014 年，访问了国家创伤数据库（NTDB）的数据。纳入年龄≥18 岁的因摩托车事故受伤且在入院时接受了确认血液酒精检测的患者。检查的其他变量为：性别、种族、创伤严重程度评分（ISS）和初始格拉斯哥昏迷量表运动评分（GCSMOT）、收缩压（SBP，mmHg）、SBP<90 和合并症。血液酒精浓度（BAC）达到或超过法定限制（0.08 g/dL）的患者构成“酒精阳性”组，而 BAC 检测为阴性的患者构成“酒精阴性”组。BAC 检测结果为 0.08 g/dL 的患者被排除在分析之外。本研究的主要结局为院内死亡率。进行了单变量和倾向匹配分析。所有 p 值均为双侧，p 值<0.05 被认为具有统计学意义。
在涉及摩托车事故的 113843 名患者中，有 67183 名患者接受了 BAC 检测。大多数（68.52%）检测结果为阴性，21.14%检测结果为法定限制以上阳性，10.34%检测结果为 BAC<0.08 g/dL。共有 29922 名患者符合最终分析的纳入标准。在进行倾向评分匹配后，匹配变量（年龄、性别、种族）的标准化均差有 100%的改善。然而，两组之间在 SBP<90、ISS 和 GCSMOT 方面仍存在差异。酒精阴性组和酒精阳性组的医院死亡率分别为 3.1%和 3.9%（P<0.001）。酒精阳性组的死亡比值比为 1.27（95%CI：1.07，1.53），医院死亡率的绝对风险差异为 0.008（CI：0.002，0.014）。
与 BAC 检测结果为阴性的患者相比，BAC 检测结果超过法定限制的患者的损伤严重程度评分更高，院内死亡率更高。
