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Figures
Fig. 1
Proportion of all trauma patients tested for alcohol by age group.
Fig. 2
Proportion tested positive for alcohol in different age groups (years) in those tested for alcohol, hypothetically assuming that those not tested would have tested negative for alcohol (lower limit estimation of proportion alcohol positive in different age groups).
Fig. 3
Mortality rates in patients positive and negative for alcohol.
Fig. 4
Injurity Severity Scores for those alcohol-positive and alcohol-negative patients in the different age groups (years).
Abstract
Background
The purpose was to determine the proportion of alcohol-positive (AlcPos) trauma patients in different age groups and any association with mortality using the National Trauma Data Bank.
Methods
Several variables were extracted from the National Trauma Data Bank (version 6.2) using MS Access 2007: age, alcohol presence, Injury Severity Score (ISS), and discharge status (alive vs dead). Age groups for logistic regression were arbitrarily defined as follows: 0 to 10, 11 to 20, 21 to 39, 40 to 64, and older than 64 years.
Results
Approximately 47% of all trauma survivors were tested for alcohol (621,174 of a total of 1,311,137), and 28% of those were AlcPos (176,107/621,174). The proportion of AlcPos patients gradually increased to maximum at 22 years, when 46% (6797/14,732) tested were AlcPos. The proportion AlcPos gradually declined to 35% by age 50 years, then to 15% (2516/16,244) by age 66 to 70 years. The ISSs were significantly higher in AlcPos patients in all age groups (P < .01). Mortality rates were higher in AlcPos children (up to age 20 years) and in adults older than 40 years. The AlcPos patients who were 21 to 39 years old had lower mortality compared with alcohol-negative patients. Logistic regression analysis (controlling for ISSs) revealed that being AlcPos did not play a role in mortality until age 21 to 39 years (AlcPos lower mortality) and in age 40 to 64 years and older than 65 years (AlcPos higher mortality).
Conclusions
Trauma patients of all ages may be AlcPos. Being AlcPos is a marker for greater injury in all age groups. After controlling for ISSs, trauma patients 40 years and older who were AlcPos have increased mortality. This study suggests a role for alcohol testing in all age groups.
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☆The contents of this manuscript were presented at the 2010 Western Regional Research Forum and Medical Student Forum, University of California, Davis, Sonoma, California, March 19-20, 2010, and SAEM Annual Meeting, Phoenix, Arizona, June 3-6, 2010.
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