Base deficit level indicating major injury is increased with ethanol

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Toxicology

Background:

• Blunt trauma patients often present with altered physiological markers.
• Ethanol intoxication can complicate the assessment of trauma severity.
• Base deficit is a key indicator of metabolic acidosis and tissue hypoperfusion.

Purpose of the Study:

• To investigate the independent effect of ethanol on base deficit in blunt trauma patients.
• To determine if ethanol influences base deficit regardless of injury severity.
• To identify potential early warning signs of occult injuries in ethanol-positive trauma patients.

Main Methods:

• Retrospective analysis of data from two Level I trauma centers.
• Inclusion of 2140 patients from Baltimore and 139 from Youngstown, Ohio.
• Statistical analysis to assess base deficit in ethanol-positive versus ethanol-negative patients, controlling for Injury Severity Score (ISS), blood pressure (BP), and blood loss.

Main Results:

• Ethanol-positive patients exhibited a significantly higher base deficit in both cohorts, independent of ISS, BP, and blood loss.
• In awake patients, a base deficit of ≤-4.1 (ethanol-positive) or ≤-1.1 (ethanol-negative) correlated with higher rates of major and abdominal trauma.
• These base deficit thresholds may indicate occult injuries in ethanol-consuming blunt trauma patients.

Conclusions:

• Ethanol independently increases base deficit in blunt trauma patients.
• Specific base deficit values may serve as early indicators for occult injuries in ethanol-positive patients.
• Consideration of abdominal CT or ultrasound is recommended for ethanol-positive blunt trauma patients with specific base deficit levels.