The impact of alcohol use and withdrawal on trauma outcomes: A case control study
Many patients admitted to hospitals with acute trauma have positive serum blood alcohol levels. Published associations between alcohol use, injury patterns, and outcomes are inconsistent. We sought to further delineate the impact of alcohol use and alcohol withdrawal on hospital outcomes amongst acu...
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| Veröffentlicht in: | The American journal of surgery 2021-08, Vol.222 (2), p.438-445 |
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| container_title | The American journal of surgery |
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| creator | Ng, Cheng Fleury, Marie Hakmi, Hazim Bronson, Brian Vosswinkel, James A. Huang, Emily C. Shapiro, Marc Jawa, Randeep S. |
| description | Many patients admitted to hospitals with acute trauma have positive serum blood alcohol levels. Published associations between alcohol use, injury patterns, and outcomes are inconsistent. We sought to further delineate the impact of alcohol use and alcohol withdrawal on hospital outcomes amongst acute trauma patients.
We performed a retrospective analysis of adult trauma patients hospitalized at a suburban level 1 trauma center between January 2015 and September 2019 with a blood alcohol level measurement and/or classification as alcohol withdrawal syndrome (AWS). Patients were separated into three groups: BAL ≤10 mg/dL, BAL >10 mg/dL, and alcohol withdrawal syndrome (AWS).
Overall, 3896 patients met study criteria with 75.6% BAL ≤10, 23.2% BAL >10, and 1.2% AWS. The median age was significantly different (BAL ≤ 10: 59 years, BAL > 10: 44 years, AWS: 53.5 years). Alcohol withdrawal was experienced by patients with BAL ≤10 and BAL >10. While injury severity and mortality were similar across all 3 groups, AWS patients experienced significantly longer hospital and ICU lengths of stay, unplanned ICU admission, need for mechanical ventilation, and higher rates of complications. Patients with AWS had high rates of acute neuropsychiatric symptoms, complicating their management.
Except for mortality, AWS patients experienced worse outcomes. The complex nature of alcohol withdrawal cases, including the possibility of developing AWS despite a negative BAL on admission, emphasizes the need for early assessment for alcohol withdrawal risk factors and input from specialists.
•Except for mortality, alcohol withdrawal syndrome patients had worse outcomes.•Patients with low and elevate blood alcohol levels experience alcohol withdrawal syndrome.•Patients with alcohol withdrawal have high rates of acute neuropsychiatric symptoms. |
| doi_str_mv | 10.1016/j.amjsurg.2020.12.026 |
| format | Article |
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We performed a retrospective analysis of adult trauma patients hospitalized at a suburban level 1 trauma center between January 2015 and September 2019 with a blood alcohol level measurement and/or classification as alcohol withdrawal syndrome (AWS). Patients were separated into three groups: BAL ≤10 mg/dL, BAL >10 mg/dL, and alcohol withdrawal syndrome (AWS).
Overall, 3896 patients met study criteria with 75.6% BAL ≤10, 23.2% BAL >10, and 1.2% AWS. The median age was significantly different (BAL ≤ 10: 59 years, BAL > 10: 44 years, AWS: 53.5 years). Alcohol withdrawal was experienced by patients with BAL ≤10 and BAL >10. While injury severity and mortality were similar across all 3 groups, AWS patients experienced significantly longer hospital and ICU lengths of stay, unplanned ICU admission, need for mechanical ventilation, and higher rates of complications. Patients with AWS had high rates of acute neuropsychiatric symptoms, complicating their management.
Except for mortality, AWS patients experienced worse outcomes. The complex nature of alcohol withdrawal cases, including the possibility of developing AWS despite a negative BAL on admission, emphasizes the need for early assessment for alcohol withdrawal risk factors and input from specialists.
•Except for mortality, alcohol withdrawal syndrome patients had worse outcomes.•Patients with low and elevate blood alcohol levels experience alcohol withdrawal syndrome.•Patients with alcohol withdrawal have high rates of acute neuropsychiatric symptoms.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2020.12.026</identifier><identifier>PMID: 33454025</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Activities of daily living ; Age ; Alcohol ; Alcohol use ; Alcohol withdrawal ; Alcohols ; Blood ; Complications ; Demographics ; Drug withdrawal ; Hospitals ; Injuries ; Intensive care ; Intoxication ; Length of stay ; Mechanical ventilation ; Medical records ; Mortality ; Patients ; Risk analysis ; Risk factors ; Toxicology ; Trauma ; Vehicles ; Ventilators</subject><ispartof>The American journal of surgery, 2021-08, Vol.222 (2), p.438-445</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-a41b5cb2b18e2ec87c92307599f154c9bef4debed08b891dc72230566b40fb9b3</citedby><cites>FETCH-LOGICAL-c393t-a41b5cb2b18e2ec87c92307599f154c9bef4debed08b891dc72230566b40fb9b3</cites><orcidid>0000-0003-4632-2913</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2554991576?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978,64366,64368,64370,72220</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33454025$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ng, Cheng</creatorcontrib><creatorcontrib>Fleury, Marie</creatorcontrib><creatorcontrib>Hakmi, Hazim</creatorcontrib><creatorcontrib>Bronson, Brian</creatorcontrib><creatorcontrib>Vosswinkel, James A.</creatorcontrib><creatorcontrib>Huang, Emily C.</creatorcontrib><creatorcontrib>Shapiro, Marc</creatorcontrib><creatorcontrib>Jawa, Randeep S.</creatorcontrib><title>The impact of alcohol use and withdrawal on trauma outcomes: A case control study</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Many patients admitted to hospitals with acute trauma have positive serum blood alcohol levels. Published associations between alcohol use, injury patterns, and outcomes are inconsistent. We sought to further delineate the impact of alcohol use and alcohol withdrawal on hospital outcomes amongst acute trauma patients.
We performed a retrospective analysis of adult trauma patients hospitalized at a suburban level 1 trauma center between January 2015 and September 2019 with a blood alcohol level measurement and/or classification as alcohol withdrawal syndrome (AWS). Patients were separated into three groups: BAL ≤10 mg/dL, BAL >10 mg/dL, and alcohol withdrawal syndrome (AWS).
Overall, 3896 patients met study criteria with 75.6% BAL ≤10, 23.2% BAL >10, and 1.2% AWS. The median age was significantly different (BAL ≤ 10: 59 years, BAL > 10: 44 years, AWS: 53.5 years). Alcohol withdrawal was experienced by patients with BAL ≤10 and BAL >10. While injury severity and mortality were similar across all 3 groups, AWS patients experienced significantly longer hospital and ICU lengths of stay, unplanned ICU admission, need for mechanical ventilation, and higher rates of complications. Patients with AWS had high rates of acute neuropsychiatric symptoms, complicating their management.
Except for mortality, AWS patients experienced worse outcomes. The complex nature of alcohol withdrawal cases, including the possibility of developing AWS despite a negative BAL on admission, emphasizes the need for early assessment for alcohol withdrawal risk factors and input from specialists.
•Except for mortality, alcohol withdrawal syndrome patients had worse outcomes.•Patients with low and elevate blood alcohol levels experience alcohol withdrawal syndrome.•Patients with alcohol withdrawal have high rates of acute neuropsychiatric symptoms.</description><subject>Activities of daily living</subject><subject>Age</subject><subject>Alcohol</subject><subject>Alcohol use</subject><subject>Alcohol withdrawal</subject><subject>Alcohols</subject><subject>Blood</subject><subject>Complications</subject><subject>Demographics</subject><subject>Drug withdrawal</subject><subject>Hospitals</subject><subject>Injuries</subject><subject>Intensive care</subject><subject>Intoxication</subject><subject>Length of stay</subject><subject>Mechanical ventilation</subject><subject>Medical records</subject><subject>Mortality</subject><subject>Patients</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Toxicology</subject><subject>Trauma</subject><subject>Vehicles</subject><subject>Ventilators</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1rFTEUhoNY7LXtT6gE3LiZ2ySTzCRupJRWhYIIdR3ycaZ3hpnJNR-W_ntT7tWFG1chyfO-5_AgdEnJlhLaXU1bs0ypxMctI6y-sS1h3Su0obJXDZWyfY02hBDWqI6SU_Q2paleKeXtG3TatlxwwsQGfX_YAR6XvXEZhwGb2YVdmHFJgM3q8dOYdz6aJzPjsOIcTVkMDiW7sED6iK-xM5V0Yc2xplIu_vkcnQxmTnBxPM_Qj7vbh5svzf23z19vru8b16o2N4ZTK5xllkpg4GTvFGtJL5QaqOBOWRi4BwueSCsV9a5n9V90neVksMq2Z-jDoXcfw88CKetlTA7m2awQStKM97LvuaS0ou__QadQ4lq300wIrhQVfVcpcaBcDClFGPQ-jouJz5oS_eJcT_roXL8415Tp6rzm3h3bi13A_039kVyBTwcAqo5fI0Sd3AirAz9GcFn7MP5nxG9d_ZSA</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Ng, Cheng</creator><creator>Fleury, Marie</creator><creator>Hakmi, Hazim</creator><creator>Bronson, Brian</creator><creator>Vosswinkel, James A.</creator><creator>Huang, Emily C.</creator><creator>Shapiro, Marc</creator><creator>Jawa, Randeep S.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4632-2913</orcidid></search><sort><creationdate>20210801</creationdate><title>The impact of alcohol use and withdrawal on trauma outcomes: A case control study</title><author>Ng, Cheng ; 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Published associations between alcohol use, injury patterns, and outcomes are inconsistent. We sought to further delineate the impact of alcohol use and alcohol withdrawal on hospital outcomes amongst acute trauma patients.
We performed a retrospective analysis of adult trauma patients hospitalized at a suburban level 1 trauma center between January 2015 and September 2019 with a blood alcohol level measurement and/or classification as alcohol withdrawal syndrome (AWS). Patients were separated into three groups: BAL ≤10 mg/dL, BAL >10 mg/dL, and alcohol withdrawal syndrome (AWS).
Overall, 3896 patients met study criteria with 75.6% BAL ≤10, 23.2% BAL >10, and 1.2% AWS. The median age was significantly different (BAL ≤ 10: 59 years, BAL > 10: 44 years, AWS: 53.5 years). Alcohol withdrawal was experienced by patients with BAL ≤10 and BAL >10. While injury severity and mortality were similar across all 3 groups, AWS patients experienced significantly longer hospital and ICU lengths of stay, unplanned ICU admission, need for mechanical ventilation, and higher rates of complications. Patients with AWS had high rates of acute neuropsychiatric symptoms, complicating their management.
Except for mortality, AWS patients experienced worse outcomes. The complex nature of alcohol withdrawal cases, including the possibility of developing AWS despite a negative BAL on admission, emphasizes the need for early assessment for alcohol withdrawal risk factors and input from specialists.
•Except for mortality, alcohol withdrawal syndrome patients had worse outcomes.•Patients with low and elevate blood alcohol levels experience alcohol withdrawal syndrome.•Patients with alcohol withdrawal have high rates of acute neuropsychiatric symptoms.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33454025</pmid><doi>10.1016/j.amjsurg.2020.12.026</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4632-2913</orcidid></addata></record> |
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| subjects | Activities of daily living Age Alcohol Alcohol use Alcohol withdrawal Alcohols Blood Complications Demographics Drug withdrawal Hospitals Injuries Intensive care Intoxication Length of stay Mechanical ventilation Medical records Mortality Patients Risk analysis Risk factors Toxicology Trauma Vehicles Ventilators |
| title | The impact of alcohol use and withdrawal on trauma outcomes: A case control study |
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