Citation

Silver GM, Albright JM, Schermer CR, Halerz M, Conrad P, Ackerman PD, Lau L, Emanuele MA, Kovacs EJ, Gamelli RL. J. Burn Care Res. 2008; 29(5): 784-789.

Affiliation

Department of Surgery, Burn Shock Trauma Institute; Alcohol Research Program; Stritch School of Medicine;Department of Medicine, Division of Endocrinology and Metabolism.

Copyright

(Copyright © 2008, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/BCR.0b013e31818481bc

PMID

18695611

PMCID

PMC2909589

Abstract

Elevated blood alcohol content (BAC) on admission is associated with poorer outcomes, TBSA and more inhalation injury. This study's purpose was to examine the effects of alcohol through a matched case-controlled study, measuring early and extended markers of clinical outcomes. The hypothesis was that patients with an elevated admission BAC would require more resuscitation and have a longer hospital stay. Admissions 16 to 75 years of age with 15 to 75% TBSA and admission BACs were identified. Patients with BAC>30 mg/dl (BAC+, cases) were matched with patients with undetectable BAC (BAC-, controls), according to age, sex, TBSA, inhalation injury and mechanism. Screening identified 258 patients, 146 with admission BACs. Twenty-seven had a BAC>/= 30 mg/dl. There were 24 matched pairs. At 24 hours, BAC+ group had larger acute physiology and chronic health evaluation II scores (23.33 vs 18.75, P< .05), fluid requirements (5.25 vs 3.82 L (cc/kg/TBSA), P< .05), and base deficit (11.15 vs 7.15, P< .05). The duration of mechanical ventilation (14.85 vs 4.23 days, P< .05), intensive care unit length of stay (22.85 vs 9.38, P< .05), hospital length of stay (28.95 vs 15.68, P< .05), and mean hospital charges ($239,507 vs $144,598, P< .05) were increased in the BAC+ patients. Despite matched baseline injury characteristics, elevated BAC was associated with poorer short term and extended clinical outcomes, illustrating the impact of alcohol intoxication on physiologic derangement after burn injury.

Language: en