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

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.

Interplay between Platelet Dysfunction and Vascular Thrombosis in Traumatic Injury

“…Conversely, bidirectional effects termed rebound effects [121] composed of initial decreased aggregation followed by hyperaggregation have been shown [123]. The mechanism for increased aggregation appears to be erythrocyte release of ADP [124] and fibrinolytic shutdown [125,126]. The bidirectional effects of alcohol may be to the early rise of acidic metabolites such as acetate in the initial phases promoting fibrinolysis, with the late inhibitory effects due to the slow release of PAI-1 that causes in vivo shutdown [127].…”

Mortality and its association with chronic alcohol-related diseases in patients admitted to the emergency department for acute alcoholic intoxication: retrospective cohort study

“…The prespecified predictors of mortality, obtained from the ED electronic registry system using ICD-9 or ICD-10 codes depending on the study period, were: (1) age at first ("baseline") admission (years); (2) male sex (0 = no; 1 = yes); (3) AUD (0 = no; 1 = yes); (4) substance use disorder (SUD) (0 = no; 1 = yes); (5) more than 1 admission to ED for trauma (0 = no; 1 = yes); (6) mental and behavioral disorders (0 = no; 1 = yes); (7) neurological disorders including non-cardiac syncope, vertigo, dizziness, and tremors (0 = no; 1 = yes); (8) cirrhosis (0 = no; 1 = yes); (9) cardiovascular disease (0 = no; 1 = yes).…”

“…There are presently no data on long-term mortality in patients with AAI admitted to the ED and all the available studies of short-term mortality of AAI performed in the ED have focused on acute consequences of alcohol abuse, e.g., major trauma [ 7 ].…”

Denying Total Hip Arthroplasty in Smokers, Patients With Alcohol Abuse or in Patients With Human Immunodeficiency Viruses. Why?

“…Among the effects that may be associated with the influence of alcohol dependence on Key words. Human immunodeficiency viruses, alcohol abuse, smoking, total hip arthroplasty, postoperative complications the occurrence of postoperative complications is affects human immunity, inhibiting T-helper cells [3], and also causing blood coagulation disorders [13,14]. These changes can increase the risk of infection and increased mortality in the event of injury [14].…”