Effects of Elevated Blood Alcohol Levels on Burn Patient Outcomes

Salomon Puyana, MD, MS; Samuel Ruiz, MD; Francisco Amador, MD; Elizabeth Young, MSN; Shaikh Hai, MD; Mark McKenney, MD, MBA; Rizal Lim, MD; Haaris Mir, MD

Disclosures

ePlasty. 2021;21(e8) 

In This Article

Discussion

Alcohol is a major cause of death in developed countries.[11] A British review reported that the incidence of alcohol-related burns had significantly increased, comprising 20% of all acute admissions in tertiary burn units.[11]

In the present study, 1,544 patients had an increased alcohol level on admission, representing 13.6% of the study group. More than half (52.3%) of acute burn patients studied in Finland were found to be under the influence of alcohol at the time of the burn injury and have underlying dependence, implying that screening for alcohol consumption on all burn patients seems necessary.[12] Albright et al also suggested routine alcohol screening upon admission based on their findings that one-third of burn patients were at-risk drinkers and more than one-fourth were binge drinkers on a monthly basis.[13]

Results from a retrospective study of 31,338 adult patients admitted to 70 burn centers from the American Burn Association National Burn Repository demonstrated an increase in mortality and LOS in burn patients with alcohol abuse as a preexisting condition.[10] It has been previously suggested by Davis et al that alcohol intoxication at the time of burn injury alters biological response and negatively impacts outcomes,[14] which may potentially explain the findings reported in the current study.

Burn patients with elevated blood alcohol levels on admission have increased fluid requirements, increased duration of mechanical ventilation, increased ICU LOS, overall hospital LOS, and a significant increase in mean hospital charges, as indicated by Silver et al in a study of 146 burn patients with elevated blood alcohol levels on admission.[15] Similar results were found in this report, as ICU LOS, days on a ventilator, and in-hospital mortality were all significantly higher in the group with increased alcohol levels. Given the retrospective nature of the study, differences in fluid requirements and surgical management between the 2 groups were not available for analysis.

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