Effect of acute alcohol intoxication on mortality, coagulation, and fibrinolysis in trauma patients

PLoS One. 2021 Mar 23;16(3):e0248810. doi: 10.1371/journal.pone.0248810. eCollection 2021.

Abstract

Background: 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.

Materials and methods: 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.

Results: 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]).

Conclusions: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alcoholic Intoxication / complications*
  • Blood Coagulation*
  • Ethanol / blood
  • Female
  • Fibrinolysis*
  • Hospital Mortality
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Phenotype
  • Wounds and Injuries / blood*
  • Wounds and Injuries / mortality*

Substances

  • Ethanol

Grants and funding

This work was supported by a 2-year Research Grant from Pusan National University. No specific other funder is to be disclosed.