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Area of Science:

  • Trauma surgery
  • Emergency medicine
  • Toxicology

Background:

  • Motor vehicle collisions (MVCs) are a leading cause of traumatic injury.
  • Alcohol intoxication is a well-established risk factor for MVCs.
  • The specific impact of alcohol intoxication on bladder injury severity and surgical intervention requires further elucidation.

Purpose of the Study:

  • To investigate the association between ethanol intoxication and the risk of bladder injury.
  • To determine if higher blood alcohol content (BAC) levels exacerbate the risk of bladder injury and subsequent surgical repair.
  • To analyze the interaction between alcohol intoxication, pelvic fracture, and seat belt use in relation to bladder injury outcomes.

Main Methods:

  • Retrospective analysis of the National Trauma Data Bank (2017-2019).
  • Inclusion of patients involved in MVCs, categorized by alcohol intoxication status.
  • Collection of demographic data, BAC levels, injury details (including pelvic fracture), and outcomes (bladder injury, surgical repair).

Main Results:

  • Over 594,000 patients were analyzed, with 16.5% testing positive for alcohol.
  • Intoxicated patients had a higher incidence of bladder injury (1% vs. 0.4%) and surgical repair (0.7% vs. 0.15%).
  • Higher BAC was independently associated with increased risk of bladder injury and surgical repair, with intoxication being more predictive than pelvic fracture above the legal limit.

Conclusions:

  • Alcohol intoxication is an independent risk factor for bladder injury and surgical repair in MVCs.
  • Trauma providers should maintain a high index of suspicion for bladder injuries in intoxicated patients.
  • The risk is particularly elevated in intoxicated patients using seat belt restraints.