Decreased incidence of venous thromboembolism found in trauma patients with positive blood alcohol concentration on admission

Am J Drug Alcohol Abuse. 2019;45(1):77-83. doi: 10.1080/00952990.2018.1504951. Epub 2018 Aug 7.

Abstract

Background: The reported incidence of venous thromboembolism (VTE) disease in trauma is 1-58% and is considered a preventable cause of mortality. Positive blood alcohol concentration (BAC) is found in 8-45% of trauma admissions; however, its association with VTE is controversial.

Objectives: We hypothesized that a positive BAC on admission would be associated with a lower rate of VTE in a large national database of trauma patients.

Methods: We queried the largest United States trauma registry, National Trauma Data Bank (2007-2015), for any patient with positive BAC on admission. The primary outcome was VTE and the secondary outcome was mortality. A multivariable logistic regression model was used for analysis.

Results: From 2,725,032 patients (70.1% male, 29.9% female), 1,800,216 (66.1%) had a negative BAC while 924,816 (33.9%) had a positive BAC. A positive BAC was associated with lower rates of VTE (OR = 0.88, CI = 0.86-0.90, p < 0.001) and mortality (OR = 0.91, CI = 0.90-0.93, p < 0.001).

Conclusion: In a large national database, trauma patients with a positive BAC were associated with a lower rate of VTE compared to those with negative BAC. Additionally, trauma patients with positive BAC had a lower association with mortality. These findings remained after adjustment of well-known risk factors for VTE and mortality, respectively.

Keywords: Alcohol; mortality; trauma; venous thromboembolism.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking / blood*
  • Blood Alcohol Content*
  • Databases, Factual
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • United States
  • Venous Thromboembolism / epidemiology*
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / mortality
  • Young Adult

Substances

  • Blood Alcohol Content