Effect of Intravenous Fluid Therapy for Acute Alcohol Intoxication on Length of Time from Arrival at the Emergency Department until Awakening: A Prospective Observational Cohort Study

Abstract

Background Acute alcohol intoxication is a common condition observed in the emergency department (ED). Intravenous fluid therapy (IVF) is often administered to treat this condition, but its effectiveness remains unclear. We therefore conducted a study to evaluate the effect of IVF on length of time from arrival at the ED until awakening, which is a novel and more appropriate variable. Methods This single-center, prospective observational study was conducted in the ED of Self-Defense Forces Central Hospital, a secondary emergency hospital in Tokyo from October 1, 2018 to July 31, 2019. Patients were assigned to groups to receive either a 1,000-mL bolus of lactated Ringer’s solution or only cannulation. The primary outcome was length of until awakening. Secondary outcomes were length of stay in the ED and the occurrence of conditions requiring extra care. Univariate and multivariate regression analyses were performed. Predictors of the occurrence of any event that required extra care were identified using a statistical model. Results The final sample included 201 patients: 109 received IVF and 92 did not. There was no significant difference in baseline characteristics between the groups. Median length of time until awakening was 211 min (interquartile range [IQR], 119 min) in the IVF group and 208 min (IQR, 149 min) in the non-IVF group (p = 0.77). Multivariate regression analysis demonstrated that the regression coefficient of IVF for length of time until awakening was − 9.55 (95% confidence interval [CI], \(-\)36.2 to 17.2). However, hemoglobin (regression coefficient, \(10.1\); 95% CI, \(0.38\)-19.9) and initial Glasgow Coma Scale score (GCS) in the ED (regression coefficient, \(-\)7.51; 95% CI, \(-\)10.8 to \(-\)4.21) were significantly associated with length of time. Conclusions This is the first study to evaluate the effect of IVF therapy on the length of time until awakening. IVF therapy is not effective in shortening the length of time in patients with acute alcohol intoxication in the ED. Routine administration of IVF is unnecessary in these patients. Further research is warranted to investigate who benefit from IVF therapy. A significance difference in Hb and GCS in this study also would give useful tips for the next study.