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Gregory J. Jurkovich, MD; Frederick P. Rivara, MD, MPH; James G. Gurney, MS, MSW; Corinne Fligner, MD; Richard Ries, MD; Beth A. Mueller, DrPH; Michael Copass, MD

JAMA. 1993;270(1):51-56.

Abstract
Objective.
—To determine the effect of acute alcohol intoxication and chronic alcohol abuse on morbidity and mortality from trauma.

Design.
—Prospective cohort study.

Patients.
—Blunt or penetrating trauma patients at least 18 years of age admitted to one trauma center or dying at the injury scene.

Main Outcome Measures.
—Mortality, complications (infection, pneumonia, respiratory failure, or multiple organ failure), and length of hospital stay.

Results.
—Acute intoxication had no effect on risk of dying—at the injury scene, within the first 24 hours of hospitalization, after the first 24 hours, or overall. Acute intoxication also did not increase the risk of complications and was associated with shorter lengths of stay. Patients with both biochemical and behavioral evidence of chronic alcohol abuse had a twofold increased risk of complications, particularly pneumonia and any infection, compared with those with no evidence of chronic alcohol abuse.

Conclusions.
—Chronic, but not acute, alcohol abuse adversely affects outcome from trauma. Attention to the problem of chronic alcohol abuse in trauma patients is necessary, and screening trauma patients for chronic alcohol abuse appears to be warranted.

(JAMA. 1993;270:51-56)

Author Affiliations
From the Departments of Surgery (Dr Jurkovich), Pediatrics (Dr Rivara), Epidemiology (Drs Rivara and Mueller and Mr Gurney), Pathology (Dr Fligner), Psychiatry (Dr Ries), and Medicine (Dr Copass), University of Washington and the Harborview Injury Prevention and Research Center, Seattle.

Footnotes
Reprint requests to Harborview Medical Center, ZA-16, 325 Ninth Ave, Seattle, WA 98104 (Dr Jurkovich).

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