Effect of Alcohol Ingestion on the Severity and Outcome in Trauma Patients

PURPOSE: Although alcohol is frequently present in injury patients, whether it exacerbates injury and whether tolerance to alcohol changes such a relationship is less clear. We investigated alcohol's role in injury and the effect of alcohol on the severity of injury. METHODS: This prospective study was performed from July 20, 2004, to October 20, 2004, at five university hospital emergency departments (ED). We studied trauma patients, excluding pediatric patients (15 year old and under), alcohol consumption over the 6 hours prior to visiting the ED and continuous drinking after injury. Patients were screened by blood tests for the presence of alcohol and were classified into two groups by alcohol consumption. The injury severity was measured by using the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS). RESULTS: The study enrolled 361 injured patients, of whom 105 were intoxicated and 256 were not intoxicated. Alcohol consumption was significantly larger in males than in females and in cases involving violence. The injury severities were not correlated with alcohol consumption significantly between intoxicated patients and not intoxicated patients. were not significantly different. However, the number of days in the intensive care unit and the mortality correlated with alcohol consumption. In patients with severe injuries (ISS> or =15, AIS> or =3), alcohol consumption was correlated with severity of the injury. CONCLUSION: Alcohol intoxication is not associated with injury severity. But in patients with severe injuries (ISS> or =15, head AIS> or =3), alcohol consumption was correlated with injury severity.

The Injury Severity Score The Injury Severity Score of Mass Casualty (Train Accident at Kyungsan, May 14 th, 1981) / 대한정형외과학회잡지

Injuries are serious problem common to all societies. Yet even within a single community, groups of injured persons differ as to the nature and severity of their injuries. The difficulty of adjusting for such variations has hampered scientific study of injured persons. Neverthless it is essential to take differences in severity of injury into account when comparing the morhidity & mortality of various groups for the purpose of evaluating their emergency & subsequent care. In order to provide the guidelines of mass emergency care & transportation, the authors analysed the 206 injured patients of train accident at Kyungsan, May 14th, 1981 and compared mortality with severity and body system of the injuries. The results were obtained as follows: l. Of 206 injured patients, most were young people & the ratio of male & female was about equal. 2. Extremities were the most frequently injured parts of body system & single injury was more common. 3. According to most severe injury of AIS, 78% of injured persons belonged to below AIS grade 3 and none was dead. 4. Average ISS of survival groups was 6 and that of death groups was 34. None was dead below average ISS of 15. 5. Death rate was higher for patients above 50 years of age, than that for young patients and there was no age difference in mortality for ISS of 50 and higher. 6. Majority of death group were invclved in multiple injuries and major cause of death were chest and head injuries. 7. Average ISS and age of hospital death group were less than those of DOA group. 8. The authors thought that it was necessary to estahlish Emergency Service System including training and education of both professionals and the pulic, hospital categorization, communication and transportation system for the mass emergency care.