THE EFFECT OF ACUTE ALCOHOL-INTOXICATION AND CHRONIC ALCOHOL-ABUSE ONOUTCOME FROM TRAUMA

Objective.-To determine the effect of acute alcohol intoxication and c hronic alcohol abuse on morbidity and mortality from trauma. Design.-P rospective cohort study. Patients.-Blunt or penetrating trauma patient s at least 18 years of age admitted to one trauma center or dying at t he injury scene. Main Outcome Measures.-Mortality, complications (infe ction, pneumonia, respiratory failure, or multiple organ failure), and length of hospital stay. Results.-Acute intoxication had no effect on risk of dying-at the injury scene, within the first 24 hours of hospi talization, after the first 24 hours, or overall. Acute intoxication a lso did not increase the risk of complications and was associated with shorter lengths of stay. Patients with both biochemical and behaviora l evidence of chronic alcohol abuse had a twofold increased risk of co mplications, particularly pneumonia and any infection, compared with t hose with no evidence of chronic alcohol-abuse. Conclusions.-Chronic, but not acute, alcohol abuse adversely affects outcome from trauma. At tention to the problem of chronic alcohol abuse in trauma patients is necessary, and screening trauma patients for chronic alcohol abuse app ears to be warranted.