Base deficit level indicating major injury is increased with ethanol

Analyses were performed to determine whether ethanol increases base deficit, independent of major injury, in blunt trauma patients from two Level I trauma centers. In 2140 Baltimore patients, base deficit was significantly higher in ethanol-positive patients (blood level greater than or equal to 0.01%), independent of blood pressure (BP), Injury Severity Score (ISS), and blood loss. In 139 Youngstown, Ohio, patients, base deficit was significantly higher in ethanol-positive patients, independent of ISS and RBC units given. Ln 1796 awake Baltimore patients, major injury was defined as an ISS > 10, presence of blood loss, or need for RBC transfusion, A base deficit less than or equal to-4.1 for ethanol-positive and less than or equal to-1.1 for ethanol-negative patients had higher rates of major injury (odds ratio 3.2 and 2.1, respectively) and abdominal trauma (odds ratio 3.6 and 3.2, respectively). In blunt trauma patients, base deficit is increased with ethanol, independent of major injury. A base deficit of less than or equal to-4.1 for ethanol-positive and less than or equal to-1.1 for ethanol-negative awake patients may be an early warning for occult injury and suggest the need for an abdominal computed tomography (CT) scan or ultrasound. (C) 2000 Elsevier Science Inc.