Citation

Wagner N, Akbarpour A, Mörs K, Voth M, Störmann P, Auner B, Lehnert M, Marzi I, Relja B. Shock 2016; 46(3): 261-269.

Affiliation

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, Germany.

Copyright

(Copyright © 2016, The Shock Society, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/SHK.0000000000000620

PMID

27058046

Abstract

BACKGROUND: The effect of alcohol consumption on inflammatory state and outcome in brain-injured patients remains controversial. We analyzed the influence of positive blood alcohol concentration (BAC) on inflammatory changes, in-hospital complications, and mortality in traumatic brain injury (TBI)-patients. PATIENTS/METHODS: Patients with an Injury Severity Score (ISS) ≥ 16 and Abbreviated Injury Scale of head (AIS-head) ≥ 3 were included upon arrival in the emergency room and grouped according to positive BAC (>0.5‰, BAC) vs. < 0.5‰ alcohol (no BAC). Injury severity, vital signs, complications, mortality and systemic interleukin (IL)-6 levels were prospectively determined, blood alcohol concentration was quantified. According to ISS, AIS-head, age and gender we performed matched-pair analysis.

RESULTS: 101 TBI-patients were included. 74 patients were dedicated to no BAC group, 27 to BAC-group. ISS was significantly higher in the no BAC-group. Positive BAC-group required significantly less packed red blood cells and fresh frozen plasma (p < 0.05). Shorter ICU-stay were found in BAC- positive patients. In-hospital complications, including single/multiple-organ failure, SIRS, sepsis, pneumonia, ARDS showed no significant differences. Systemic IL-6 levels and leukocyte counts (IL-6: 65.0 ± 8.0 vs. 151.8 ± 22.3, leukocytes: 10.2 ± 0.9 vs. 13.2 ± 0.8, both p < 0.05) were significantly lower in BAC-positive patients. Matched-pair analysis was performed with 27 pairs. No significant differences in transfusions were monitored after matching. However, lowered systemic IL-6 levels and leukocyte counts in the BAC-group were detected after matching also, indicating that this effect is ISS-independent.

CONCLUSIONS: This study shows that positive BAC in TBI-patients is associated with lower systemic IL-6 levels and leukocyte numbers indicating that positive BAC may have immune-suppressive effects in this cohort of patients compared to TBI patients who were not alcohol-intoxicated.

Language: en