Abstract
The effect of alcohol on the outcome and fibrinolysis phenotype in trauma patients remains unclear. Hence, we performed this study to determine whether alcohol is a risk factor for mortality and fibrinolysis shutdown in trauma patients. A total of 686 patients who presented to our trauma center and underwent rotational thromboelastometry were included in the study. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to determine whether alcohol was an independent risk factor for in-hospital mortality and fibrinolysis shutdown. The rate of in-hospital mortality was 13.8% and blood alcohol was detected in 27.7% of the patients among our study population. The patients in the alcohol-positive group had higher mortality rate, higher clotting time, and lower maximum lysis, more fibrinolysis shutdown, and hyperfibrinolysis than those in the alcohol-negative group. In logistic regression analysis, blood alcohol was independently associated with in-hospital mortality (odds ratio [OR] 2.578; 95% confidence interval [CI], 1.550-4.288) and fibrinolysis shutdown (OR 1.883 [95% CI, 1.286-2.758]). Within the fibrinolysis shutdown group, blood alcohol was an independent predictor of mortality (OR 2.168 [95% CI, 1.030-4.562]). Alcohol is an independent risk factor for mortality and fibrinolysis shutdown in trauma patients. Further, alcohol is an independent risk factor for mortality among patients who experienced fibrinolysis shutdown.
Highlights
Alcohol is a major risk factor for trauma, and 30–50% of trauma cases involve acute alcohol intoxication [1,2,3]
The rate of in-hospital mortality was 13.8% and blood alcohol was detected in 27.7% of the patients among our study population
Blood alcohol was independently associated with in-hospital mortality and fibrinolysis shutdown
Summary
Alcohol is a major risk factor for trauma, and 30–50% of trauma cases involve acute alcohol intoxication [1,2,3]. Given the fatal effect of coagulopathy in severe cases of trauma, the clinical outcome of alcohol-intoxicated trauma cases is expected to be poor [9]. Effects of alcohol on the outcome in trauma patients remain unclear, and several studies have shown that the outcome of alcohol intoxicated patients is superior to that of patients who are not intoxicated [2, 10,11,12]. Recent studies using VHAs have shown that alcohol impairs clot formation and inhibits fibrinolysis [2]. The effect of alcohol on the outcome and fibrinolysis phenotype in trauma patients remains unclear. We performed this study to determine whether alcohol is a risk factor for mortality and fibrinolysis shutdown in trauma patients
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