Alcohol Biomarkers in Patients Admitted for Trauma
Alcohol Biomarkers in Patients Admitted for Trauma
复制标题
DOI：
10.1111/j.1530-0277.2009.01016.x
复制
发表时间：
2009-10-01
影响因子：
3.2
通讯作者：
Williams, Andrea
中科院分区：
文献类型：
--
作者：
Fleming, Michael;Bhamb, Bhushan;Williams, Andrea
背景：为了评估血酒精水平（BAL）和碳水化合物缺乏转铁蛋白（CDT）在创伤patients.Methods的价值：一项前瞻性研究，在213例创伤后入院的大学医院。关注的结果包括酒精戒断，感染，呼吸问题，心脏事件，血栓栓塞，和stay. Results的长度的发展：在这项研究中的创伤患者的大多数（78%）是18岁以上的男性。据报道，75%的人在过去30天内饮用含酒精饮料，34%的人有≥ 5天的重度饮酒，18.7%的人符合目前的DSM-IV酒精滥用标准，13.1%的人符合目前的依赖标准。22%（n = 48）的BAL阳性，14%（n = 30）的CDT水平> 2.5%。12%（n = 27）的样本出现酒精戒断，55%（n = 113）在住院期间发生了一次或多次不良健康事件。酒精戒断的发展与入院CDT > 2.5%（KH 2：4.77，p < 0.029）和/或BAL阳性（KH 2：54.01，p < 0.001）相关。酒精生物标志物确定了13名男性和3名女性高风险患者（占总样本的7.4%），他们否认过度饮酒，如果不使用这些标志物，他们将被遗漏。由25个不良健康事件组成的复合创伤发病率评分与阳性BAL相关（p < 0.022）。结论：该研究提供了额外的经验证据，支持在所有因创伤入院的患者中使用BAL。CDT在创伤患者中的有用性尚不清楚，需要在更危重的患者中进行更大的样本。
Background:To assess the value of blood alcohol levels (BAL) and carbohydrate-deficient transferrin (CDT) in trauma patients.Methods:A prospective study was conducted among 213 patients admitted to a university hospital after trauma. Outcomes of interest included the development of alcohol withdrawal, infections, respiratory problems, cardiac events, thromboembolism, and length of stay.Results:The majority (78%) of the trauma patients in the study was males over the age of 18. Seventy-five percent were reported drinking an alcohol-containing beverage in the previous 30 days, 34% had >= 5 heavy drinking days, and 18.7% met current DSM-IV criteria for alcohol abuse and 13.1% current criteria for dependence. Twenty-two percent (n = 48) had a positive BAL and 14% (n = 30) a CDT level > 2.5%. Twelve percent (n = 27) of the sample developed alcohol withdrawal and 55% (n = 113) had one or more adverse health events during their hospitalization. The development of alcohol withdrawal was associated with an admission CDT > 2.5% (KH2: 4.77, p < 0.029) and/or a positive BAL (KH2: 54.01, p < 0.001). The alcohol biomarkers identified 13 male and 3 female high-risk patients (7.4% of the total sample) who denied excessive alcohol use, and who would have been missed if these markers were not used. A composite morbidity trauma score composed of 25 adverse health events was associated with a positive BAL (p < 0.022).Conclusion:The study provides additional empirical evidence that supports the use of BAL in all patients admitted for trauma. The usefulness of CDT in trauma patients remains unclear and will require larger samples in more critically ill patients.