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European Journal of Trauma and Emergency Surgery

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01-10-2019 | Original Article

The alcohol-intoxicated trauma patient: impact on imaging and radiation exposure

Authors: Christian David Weber, Jana Kristina Schmitz, Christina Garving, Klemens Horst, Hans-Christoph Pape, Frank Hildebrand, Philipp Kobbe

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2019

Abstract

Introduction

The purpose of this study was to investigate the effects of alcohol intoxication in trauma patients in regard to its impact on application of computed tomography (CT) and associated radiation exposure.

Methods

We conducted a retrospective study from a continuous patient cohort. Inclusion criteria: admission to the emergency room of an urban Level 1 trauma center with trauma team activation during a 12-month period (Jan 1st–Dec 31st 2012). Patients with incomplete data, age ≤ 12 years and with neurological diseases were excluded. Demographics, mechanisms, severity and patterns of injury (Abbreviated Injury Scale, Injury Severity Score, Glasgow Coma Scale), blood alcohol concentration (BAC, in permille, ‰), imaging studies (head/whole body CT), radiation exposure, and hospital length of stay, surgical procedures and mortality were evaluated with SPSS statistics (Version 25, IBM Inc., Armonk, New York).

Results

A positive BAC (mean 1.80 ± 0.767) was reported in 19.2% (n = 41/214) of the cohort. Alcohol intoxication was associated with higher utilization of head CT (65.9 vs. 46.8%, p = 0.017) and radiation exposure (231.75 vs. 151.25 mAS, p = 0.045; dose-length product, 583.03 vs. 391.04, p = 0.006). In general, the presence of alcohol was associated with over-triage (p = 0.001), despite minor injury severity (ISS < 9) and a comparable rate of head injuries (p = 0.275). Head injury (AIS ≥ 3) and positive BAC (OR 2.34, 95% CI 1.096–5.001) were identified as strongest independent predictors for head CT.

Conclusion

Alcohol intoxication is a common finding in trauma patients, and the rate of moderate and serious head injuries seems to be comparable to a more severely injured control group. Furthermore, head CT utilization in intoxicated patients is associated with significant radiation exposure, despite poor image quality, due to motion artifacts (27%). Future strategies are required to exclude head injuries safely, while reducing the rate of head CT and associated radiation exposure in intoxicated patients.

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Title: The alcohol-intoxicated trauma patient: impact on imaging and radiation exposure
Authors: Christian David Weber
Jana Kristina Schmitz
Christina Garving
Klemens Horst
Hans-Christoph Pape
Frank Hildebrand
Philipp Kobbe
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-018-0945-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The alcohol-intoxicated trauma patient: impact on imaging and radiation exposure

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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