Assessing the impact of blood alcohol concentration on the rate of in-hospital mortality following traumatic motor vehicle crash injury: A matched analysis of the National Trauma Data Bank

Background: The purpose of this study was to compare the outcomes of trauma patients who were injured in a motor vehicle crash and tested positive for alcohol upon hospital arrival versus those who tested negative. Methods: Study data came from the US National Trauma Data Bank (2007-2010). Any blood alcohol concentration (BAC) found at or above the legal limit (>= 0.08 g/dL) was considered "alcohol positive", and if no alcohol was identified through testing, the patient was considered "alcohol negative". Patients' demographics including age > = 14, race, gender, drug test results, systolic blood pressure, heart rate, injury severity score (ISS), and Glasgow Coma Scale (GCS) were included in the study. Propensity score and exact pair matching were performed between the groups using baseline characteristics. Results: From a total of 88,794 patients, 30.9% tested positive and 69.1% tested negative for alcohol. There were significant differences found between the groups regarding age, gender, race, and GCS (all p <0.001) as well as a significantly higher in-hospital mortality rate (3.5% vs. 2.7%, p <0.001) and median time to patient expiration (4 vs. 3 days, p <0.001) in the alcohol negative group. After running both matching scenarios, there was no evidence of a significant difference seen in the rates of in-hospital mortality or the median time to patient expiration between the alcohol groups in either matched comparison. Conclusion: Patients who tested positive for alcohol following a traumatic motor vehicle crash showed no significant increase in in-hospital mortality or time to expiration when compared to propensity score and exact matched patients who tested negative for alcohol. (C) 2018 Elsevier Ltd. All rights reserved.