Effects of alcohol intoxication on the initial assessment of trauma patients

Gregory Jurkovich, Frederick P. Rivara, James G. Gurney, Debra Seguin, Corinne L. Fligner, Michael Copass

Research output: Contribution to journalArticle

95 Scopus citations

Abstract

Study objectives: To evaluate the influence of alcohol intoxication on the initial assessment and treatment of trauma patients. Design: A prospective study of 2,237 trauma patients 18 years of age or older admitted to a Level I trauma center over a 19-month period. Results: The study population was primarily male (78%) and white (73%) and had sustained blunt trauma (79%). One thousand fifty-three patients (47.1%) had positive blood alcohol concentration (BAC); median BAC in patients with any detectable alcohol was 179 mg/dL. When stratified by injury severity categories and compared with nonintoxicated (BAC less than 100 mg/dL) patients, intoxicated patients with an Injury Severity Score (ISS) of 1 to 15 were more likely to undergo the following: field and/or ED intubation (relative risk [RR], 2.22; 95% confidence interval [Cl], 1.7 to 2.7); diagnostic peritoneal lavage (RR, 1.83; Cl, 1.43 to 2.3); head computed tomography scanning (RR, 1.18; Cl, 1.0 to 1.4); and intracranial pressure monitoring (RR, 1.41; Cl, 0.74 to 2.7). The effects were less pronounced for those patients with an ISS of more than 15, except for intracranial pressure monitoring where patients with an ISS of more than 15 were 47% more likely to have intracranial pressure monitoring if intoxicated (RR, 1.47; Cl, 1.2 to 1.9). Conclusion: Acute intoxication appears to alter the initial assessment of injury severity, resulting in an increased use of invasive diagnostic and therapeutic procedures.

Original languageEnglish (US)
Pages (from-to)704-708
Number of pages5
JournalAnnals of Emergency Medicine
Volume21
Issue number6
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • alcohol, trauma
  • trauma, alcohol

ASJC Scopus subject areas

  • Emergency Medicine

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