Patient mortality following alcohol use and trauma: a propensity-matched analysis

To examine the outcomes of trauma patients who tested positive for alcohol at the time of hospital arrival versus those who tested negative.

Data were pulled from the National Trauma Data Bank (2007-2010). All injured patients who were ≥14 years of age, sustained a "blunt" or "penetrating" injury, had complete systolic blood pressure (SBP) and heart rate (HR) records, were taken to a level 1 or 2 trauma center, and who received a confirmed blood alcohol test were included in the study. Any blood alcohol concentration (BAC) above the legal limit (≥0.08 g/dL) was considered "positive" for alcohol, and if no alcohol was identified it was considered "negative". Patients' demography and clinical information were compared across groups using Chi-square and Wilcoxon rank sum tests. Logistic regression, propensity score matching, and a follow-up paired analysis were also performed.

Of 279,460 total patients, around one-third of the patients (92,960) tested positive for BAC. There were clear demographic differences found between the two groups regarding age, gender, race, and injury type. There was also a significantly higher mortality rate (4.3 vs. 3.1%, P < 0.001) and a longer hospital length of stay (4 vs. 3 days, P < 0.001) found in the alcohol-negative group. Propensity score matching was also performed resulting in 92,959 patients per group. Using the paired data, the overall mortality observed was 3.1 vs. 3.3% (P = 0.035) between the alcohol-positive and alcohol-negative groups, respectively. There was no significant difference noted in the total hospital length of stay (median: 3 vs. 4 days, P = 0.84).

Patients who tested positive for alcohol following a traumatic injury showed no clinically significant reduction in mortality and no significant difference in total hospital length of stay.