Positive blood alcohol is associated with reduced DVT in trauma

Mackenzie R. Cook, Scott G. Louis, Sean P. McCully, Ryland S. Stucke, Sonya P. Fabricant, Martin Schreiber

    Research output: Contribution to journalArticle

    3 Citations (Scopus)

    Abstract

    Introduction Trauma patients exhibit a complex coagulopathy which is not fully understood and deep venous thrombosis (DVT) rates remain high. The effects of alcohol (EtOH) consumption on coagulopathy in trauma patients have not been studied. We hypothesized that acute EtOH intoxication would produce a relative hypocoagulable state as measured by thrombelastography (TEG) and would be associated with reduced DVT rates. Methods Data were prospectively collected on 213 trauma patients at a level 1 trauma centre and analyzed in a retrospective secondary analysis. Thrombelastography (TEG), standard laboratory tests and ETOH levels were performed. If the level was positive, patients were grouped as EtOH+ and all patients were screened for DVT using a standard protocol. Statistical significance was p <0.05. Results The EtOH+ group was predominantly male (76%), was younger (p <0.05), had a lower BMI (p <0.05), demonstrated a lower AIS extremity score (p <0.01) and was less likely to have a blunt injury (p <0.01) than the EtOH- group. Gender, ISS and other AIS scores were not significantly different. TEG values in the alcohol group demonstrated a relative hypocoagulable state that was associated with a reduced DVT incidence, 1.4% versus 16.2%, (p <0.01). This difference was not detected with conventional assays. A multivariate logistic regression was performed, controlling for common risk factors for DVT and a positive EtOH level on admission was independently associated with reduced DVT incidence. Conclusions Alcohol consumption is associated with a relative hypocoagulable state on TEG that is associated with a decreased DVT incidence. This difference is not detected by conventional assays.

    Original languageEnglish (US)
    Pages (from-to)131-135
    Number of pages5
    JournalInjury
    Volume46
    Issue number1
    DOIs
    StatePublished - Jan 1 2015

    Fingerprint

    Venous Thrombosis
    Thrombelastography
    Alcohols
    Wounds and Injuries
    Alcohol Drinking
    Incidence
    Alcoholic Intoxication
    Nonpenetrating Wounds
    Disseminated Intravascular Coagulation
    Trauma Centers
    Lower Extremity
    Logistic Models

    Keywords

    • Alcohol
    • Deep vein thrombosis
    • Thrombelastogram
    • Trauma
    • Venous thromboembolism

    ASJC Scopus subject areas

    • Emergency Medicine
    • Orthopedics and Sports Medicine

    Cite this

    Cook, M. R., Louis, S. G., McCully, S. P., Stucke, R. S., Fabricant, S. P., & Schreiber, M. (2015). Positive blood alcohol is associated with reduced DVT in trauma. Injury, 46(1), 131-135. https://doi.org/10.1016/j.injury.2014.09.017

    Positive blood alcohol is associated with reduced DVT in trauma. / Cook, Mackenzie R.; Louis, Scott G.; McCully, Sean P.; Stucke, Ryland S.; Fabricant, Sonya P.; Schreiber, Martin.

    In: Injury, Vol. 46, No. 1, 01.01.2015, p. 131-135.

    Research output: Contribution to journalArticle

    Cook, MR, Louis, SG, McCully, SP, Stucke, RS, Fabricant, SP & Schreiber, M 2015, 'Positive blood alcohol is associated with reduced DVT in trauma', Injury, vol. 46, no. 1, pp. 131-135. https://doi.org/10.1016/j.injury.2014.09.017
    Cook MR, Louis SG, McCully SP, Stucke RS, Fabricant SP, Schreiber M. Positive blood alcohol is associated with reduced DVT in trauma. Injury. 2015 Jan 1;46(1):131-135. https://doi.org/10.1016/j.injury.2014.09.017
    Cook, Mackenzie R. ; Louis, Scott G. ; McCully, Sean P. ; Stucke, Ryland S. ; Fabricant, Sonya P. ; Schreiber, Martin. / Positive blood alcohol is associated with reduced DVT in trauma. In: Injury. 2015 ; Vol. 46, No. 1. pp. 131-135.
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    abstract = "Introduction Trauma patients exhibit a complex coagulopathy which is not fully understood and deep venous thrombosis (DVT) rates remain high. The effects of alcohol (EtOH) consumption on coagulopathy in trauma patients have not been studied. We hypothesized that acute EtOH intoxication would produce a relative hypocoagulable state as measured by thrombelastography (TEG) and would be associated with reduced DVT rates. Methods Data were prospectively collected on 213 trauma patients at a level 1 trauma centre and analyzed in a retrospective secondary analysis. Thrombelastography (TEG), standard laboratory tests and ETOH levels were performed. If the level was positive, patients were grouped as EtOH+ and all patients were screened for DVT using a standard protocol. Statistical significance was p <0.05. Results The EtOH+ group was predominantly male (76{\%}), was younger (p <0.05), had a lower BMI (p <0.05), demonstrated a lower AIS extremity score (p <0.01) and was less likely to have a blunt injury (p <0.01) than the EtOH- group. Gender, ISS and other AIS scores were not significantly different. TEG values in the alcohol group demonstrated a relative hypocoagulable state that was associated with a reduced DVT incidence, 1.4{\%} versus 16.2{\%}, (p <0.01). This difference was not detected with conventional assays. A multivariate logistic regression was performed, controlling for common risk factors for DVT and a positive EtOH level on admission was independently associated with reduced DVT incidence. Conclusions Alcohol consumption is associated with a relative hypocoagulable state on TEG that is associated with a decreased DVT incidence. This difference is not detected by conventional assays.",
    keywords = "Alcohol, Deep vein thrombosis, Thrombelastogram, Trauma, Venous thromboembolism",
    author = "Cook, {Mackenzie R.} and Louis, {Scott G.} and McCully, {Sean P.} and Stucke, {Ryland S.} and Fabricant, {Sonya P.} and Martin Schreiber",
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    T1 - Positive blood alcohol is associated with reduced DVT in trauma

    AU - Cook, Mackenzie R.

    AU - Louis, Scott G.

    AU - McCully, Sean P.

    AU - Stucke, Ryland S.

    AU - Fabricant, Sonya P.

    AU - Schreiber, Martin

    PY - 2015/1/1

    Y1 - 2015/1/1

    N2 - Introduction Trauma patients exhibit a complex coagulopathy which is not fully understood and deep venous thrombosis (DVT) rates remain high. The effects of alcohol (EtOH) consumption on coagulopathy in trauma patients have not been studied. We hypothesized that acute EtOH intoxication would produce a relative hypocoagulable state as measured by thrombelastography (TEG) and would be associated with reduced DVT rates. Methods Data were prospectively collected on 213 trauma patients at a level 1 trauma centre and analyzed in a retrospective secondary analysis. Thrombelastography (TEG), standard laboratory tests and ETOH levels were performed. If the level was positive, patients were grouped as EtOH+ and all patients were screened for DVT using a standard protocol. Statistical significance was p <0.05. Results The EtOH+ group was predominantly male (76%), was younger (p <0.05), had a lower BMI (p <0.05), demonstrated a lower AIS extremity score (p <0.01) and was less likely to have a blunt injury (p <0.01) than the EtOH- group. Gender, ISS and other AIS scores were not significantly different. TEG values in the alcohol group demonstrated a relative hypocoagulable state that was associated with a reduced DVT incidence, 1.4% versus 16.2%, (p <0.01). This difference was not detected with conventional assays. A multivariate logistic regression was performed, controlling for common risk factors for DVT and a positive EtOH level on admission was independently associated with reduced DVT incidence. Conclusions Alcohol consumption is associated with a relative hypocoagulable state on TEG that is associated with a decreased DVT incidence. This difference is not detected by conventional assays.

    AB - Introduction Trauma patients exhibit a complex coagulopathy which is not fully understood and deep venous thrombosis (DVT) rates remain high. The effects of alcohol (EtOH) consumption on coagulopathy in trauma patients have not been studied. We hypothesized that acute EtOH intoxication would produce a relative hypocoagulable state as measured by thrombelastography (TEG) and would be associated with reduced DVT rates. Methods Data were prospectively collected on 213 trauma patients at a level 1 trauma centre and analyzed in a retrospective secondary analysis. Thrombelastography (TEG), standard laboratory tests and ETOH levels were performed. If the level was positive, patients were grouped as EtOH+ and all patients were screened for DVT using a standard protocol. Statistical significance was p <0.05. Results The EtOH+ group was predominantly male (76%), was younger (p <0.05), had a lower BMI (p <0.05), demonstrated a lower AIS extremity score (p <0.01) and was less likely to have a blunt injury (p <0.01) than the EtOH- group. Gender, ISS and other AIS scores were not significantly different. TEG values in the alcohol group demonstrated a relative hypocoagulable state that was associated with a reduced DVT incidence, 1.4% versus 16.2%, (p <0.01). This difference was not detected with conventional assays. A multivariate logistic regression was performed, controlling for common risk factors for DVT and a positive EtOH level on admission was independently associated with reduced DVT incidence. Conclusions Alcohol consumption is associated with a relative hypocoagulable state on TEG that is associated with a decreased DVT incidence. This difference is not detected by conventional assays.

    KW - Alcohol

    KW - Deep vein thrombosis

    KW - Thrombelastogram

    KW - Trauma

    KW - Venous thromboembolism

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