Alcohol and Trauma: Blood Test Gets to the Truth

FRIDAY July 24, 2009 -- Testing the blood-alcohol level of trauma patients could help medical personnel identify those at risk for further complications from drinking issues, a new study says.

People who abuse alcohol often deny doing so, leaving medical personnel in the dark about potentially serious health needs. But even if people withhold this information, a blood test might indicate if they are likely to suffer withdrawal or other health problems during hospitalization, the researchers said. Their work appears online and in the October print issue of Alcoholism: Clinical & Experimental Research.

"Alcohol use is associated with higher rates of motor vehicle accidents, falls, injuries inflicted by weapons and workplace injuries than in persons not using alcohol," the study's corresponding author, Dr. Michael F. Fleming, a professor of family medicine at the University of Wisconsin School of Medicine and Public Health, said in a university news release. "In addition, patients processed through emergency may not be aware of their injury severity until the alcohol is out of their system, and in persons suffering from head trauma, it is difficult to assess changes in mental status."

The study of 213 people admitted to a university hospital with trauma injuries found that about 22 percent had positive blood-alcohol levels and 12 percent later developed alcohol withdrawal. More than half of all the patients suffered additional health events during their hospital stay. The tests also identified 16 people, or 7.4 percent, as high-risk even though, when questioned at admission time, they said they had not been drinking.

"Elevated BAL [blood-alcohol level] at the time of admission is associated with higher rates of complications," Fleming said, "and strongly predict the development of delirium treatments."

Other alcohol biomarkers, such as carbohydrate deficient transferin, may be helpful in evaluating trauma patients, but more testing is needed to confirm their clinical use, he said.

"Alcohol is the single most robust risk factor for physical trauma," Jean-Bernard Daeppen, a professor of medicine at Lausanne University Hospital in Switzerland, said in the news release. "An elevated BAL is not just having a glass before trauma. Most patients admitted with positive BALs after trauma have an alcohol-use disorder, often severe."

Fleming dismissed some concerns that insurance companies might refuse payment if a person tests positive for alcohol. "This is like saying they are not going to pay for treatment of a heart attack or asthma or a stroke in someone who admits to smoking," he said.

"Just because someone is drinking does not mean alcohol caused the accident," Daeppen said. "All we really know is that theirs is a greater risk."

More information

The U.S. Centers for Disease Control and Prevention has more about alcohol use.

Posted: July 2009


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