Does alcohol intoxication alter the assessment and outcome of "observation-status" trauma patients?

We assessed the effect of blood alcohol concentration (BAC) on the evaluati on, outcome, and hospital charges of our observation-status trauma patient population. We conducted a retrospective study over 18 months; any patient initially admitted with < 24-hour observation status, Glasgow Coma Score of 15, and negative drug screen was eligible. Patients were divided on the ba sis of BAC (BAC+ = > 80 mg/dL; BAC- = < 80 mg/dL). Two hundred twenty-six p atients were observed during the study (2765 admissions). For the 66 BAC+ p atients (range 90-392 mg/dL) there was a strong male predominance. There wa s no difference in diagnostic evaluation schema, delayed diagnosis, complic ations, cost, or conversions to full admission between the groups. We concl ude that evaluation, outcome, and charges of observation trauma patients ar e the same regardless of BAC. Intoxication did not mask injury; therefore B AC+ patients do not require observation on the sole basis of intoxication i f their evaluation is otherwise negative.