Assessing the impact of blood alcohol concentration on the rate of in-hospital mortality following traumatic motor vehicle crash injury: A matched analysis of the National Trauma Data Bank

Injury ◽  
2019 ◽  
Vol 50 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Nasim Ahmed ◽  
Patricia Greenberg
Keyword(s):  
Hospital Mortality ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Data Bank ◽  
Alcohol Concentration ◽  
Motor Vehicle Crash ◽  
Blood Alcohol ◽  
National Trauma ◽  
National Trauma Data Bank ◽  
The Impact

Impact of Early Decompressive Craniectomy Following Blunt Traumatic Brain Injury on Mortality: Propensity Matched Analysis

2017 ◽  
Vol 78 (05) ◽  
pp. 453-459 ◽  
Author(s):  
Nasim Ahmed
Keyword(s):  
Hospital Mortality ◽  
Absolute Risk ◽  
Absolute Risk Reduction ◽  
Data Bank ◽  
Data Set ◽  
Hospital Arrival ◽  
National Trauma ◽  
National Trauma Data Bank ◽  
The Impact ◽  
Late Group

Background The purpose of this study was to evaluate the impact of the early craniectomy on mortality. Hypothesis Early craniectomy within 4 hours of hospital arrival will reduce in-hospital mortality. Methods Data were retrieved from the National Trauma Data Bank data set (RDS_2007-RDS_2010). All craniectomies performed on patients with a blunt mechanism of head injury within 24 hours of admission were included in the study. In-hospital mortality was the main outcome of interest. Results A total of 942 patients qualified for the study. Overall, 669 patients (71%) underwent a craniectomy within 4 hours (early group), and 273 patients (29%) had a craniectomy performed between > 4 hours to 24 hours following hospital arrival (late group). Propensity matched analysis identified 268 pairs of patients in both groups. The mean standardized differences were < 10% after matching. There were no significant differences in mortality (odds ratio: 1.018; confidence interval [CI], 0.689–1.506; p = 1.00), absolute risk reduction (0.004; 95% CI, − 0.078 to 0.085; p = 1.00), and length of stay (LOS) between the groups (hazard ratio: 0.770; 95% CI, 0.56–1.059; p = 0.108). Conclusion No differences were seen on in-hospital mortality and hospital LOS between patients operated within 4 hours versus patients operated between 4 and 24 hours of admission.

A Positive Blood Alcohol Concentration Is the Main Predictor of Recurrent Motor Vehicle Crash

2005 ◽  
Vol 46 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Andrea Fabbri ◽  
Giulio Marchesini ◽  
Massimo Dente ◽  
Tiziana Iervese ◽  
Marco Spada ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Motor Vehicle Crash ◽  
Blood Alcohol ◽  
Vehicle Crash

Associated Injuries in Traumatic Sternal Fractures: A Review of the National Trauma Data Bank

2013 ◽  
Vol 79 (7) ◽  
pp. 702-705 ◽  
Author(s):  
Tolulope A. Oyetunji ◽  
Hope T. Jackson ◽  
Augustine C. Obirieze ◽  
Danier Moore ◽  
Marc J. Branche ◽  
...  
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Cardiac Injury ◽  
Data Bank ◽  
Motor Vehicle Crash ◽  
Associated Injuries ◽  
Severe Injuries ◽  
National Trauma ◽  
National Trauma Data Bank ◽  
Sternal Fractures

Sternal fractures occur infrequently with blunt force trauma. The demographics and epidemiology of associated injuries have not been well characterized from a national trauma database. The National Trauma Data Bank was queried for patients with closed sternal fractures. The demographics were analyzed by age, gender, mechanism and indicators of anatomic and physiologic injuries. Types of commonly associated injuries were also determined. A total of 23,985 records were analyzed. Males accounted for 68.3 per cent and whites 70.9 per cent. Motor vehicle crash was the leading mechanism. More than 56 per cent had severe injuries based on Injury Severity Score (greater than 15) and 17 per cent with Glasgow Coma Score 8 or less. Crude mortality was 7.9 per cent. The majority (57.8%) and approximately one-third (33.7%) of the patients had rib fractures and lung contusions, respectively, 22.0 per cent with closed pneumothorax, 21.6 per cent had a closed thoracic vertebra fracture, 16.9 per cent with lumbar spine fracture, 3.9 per cent with concussion, and blunt cardiac injury in 3.6 per cent. Sternal fractures are usually associated with severe blunt trauma. Lung contusion remains the leading associated injury followed by vertebral spine fractures. Cardiac injuries are less frequent and vascular injuries less so. Mechanism of injury and presence of sternal fractures should alert providers to these potential associated injuries.

Trends in Cannabis Involvement and Risk of Alcohol Involvement in Motor Vehicle Crash Fatalities in the United States, 2000‒2018

2021 ◽  
pp. e1-e10
Author(s):  
Marlene C. Lira ◽  
Timothy C. Heeren ◽  
Magdalena Buczek ◽  
Jason G. Blanchette ◽  
Rosanna Smart ◽  
...  
Keyword(s):  
United States ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
The United States ◽  
Alcohol Concentration ◽  
Motor Vehicle Crash ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Vehicle Crash ◽  
Alcohol Involvement

Objectives. To assess cannabis and alcohol involvement among motor vehicle crash (MVC) fatalities in the United States. Methods. In this repeated cross-sectional analysis, we used data from the Fatality Analysis Reporting System from 2000 to 2018. Fatalities were cannabis-involved if an involved driver tested positive for a cannabinoid and alcohol-involved based on the highest blood alcohol concentration (BAC) of an involved driver. Multinomial mixed-effects logistic regression models assessed cannabis as a risk factor for alcohol by BAC level. Results. While trends in fatalities involving alcohol have remained stable, the percentage of fatalities involving cannabis and cannabis and alcohol increased from 9.0% in 2000 to 21.5% in 2018, and 4.8% in 2000 to 10.3% in 2018, respectively. In adjusted analyses, fatalities involving cannabis had 1.56 (95% confidence interval [CI] = 1.48, 1.65), 1.62 (95% CI = 1.52, 1.72), and 1.46 (95% CI = 1.42, 1.50) times the odds of involving BACs of 0.01% to 0.049%, 0.05% to 0.079%, and 0.08% or higher, respectively. Conclusions. The percentage of fatalities involving cannabis and coinvolving cannabis and alcohol doubled from 2000 to 2018, and cannabis was associated with alcohol coinvolvement. Further research is warranted to understand cannabis- and alcohol-involved MVC fatalities. (Am J Public Health. Published online ahead of print October 28, 2021:e1–e10. https://doi.org/10.2105/AJPH.2021.306466 )

“Nurse, I Only Had a Couple of Beers”: Validity of Self-reported Drinking Before Serious Vehicular Injury

2002 ◽  
Vol 11 (2) ◽  
pp. 106-114 ◽  
Author(s):  
Marilyn Sawyer Sommers ◽  
Janice M. Dyehouse ◽  
Steven R. Howe ◽  
Kathryn Wekselman ◽  
Michael Fleming
Keyword(s):  
Alcohol Consumption ◽  
Motor Vehicle ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Alcohol Intervention ◽  
Blood Alcohol ◽  
Traffic Crashes ◽  
The Mean ◽  
Reported Data ◽  
Vehicular Crashes

• Background Of the more than 40 000 Americans killed each year in vehicular crashes, 40% are involved in alcohol-related collisions. Although self-reported alcohol use has become an anchor for alcohol intervention after traffic crashes, clinicians are often skeptical about the truthfulness of self-reporting. • Objective To determine the validity of self-reported alcohol consumption of vehicular occupants hospitalized for a serious, alcohol-related injury. • Methods Non-alcohol–dependent subjects 18 years and older who were injured in motor vehicle crashes were interviewed. The self-reported number of standard drinks, time that drinking commenced, sex, and weight were used to calculate estimated blood alcohol concentration. This value was compared with the blood alcohol concentration measured at admission. • Results Of the 181 subjects, 60% provided sufficient data to calculate the estimated concentration. Seven men with admission concentrations of 10 mg/dL or more denied drinking. Among the 113 subjects with estimated concentrations who acknowledged drinking (excluding the 7 who denied drinking), the mean concentration at admission was 158.67 mg/dL, and mean estimated concentration was 83.81 mg/dL. According to multiple regression analyses, weight and number of drinks accounted for 3% of the variance in alcohol concentration at admission for women (R =0.174, F2,40 = 0.623, P = .54) and for 29% of the variance in men (R=0.543, F2,128 =26.71, P&lt; .001). • Conclusions Most persons who drink before vehicular injury acknowledge drinking. Self-reported data from men generally reflect the overall trend of alcohol consumption but with systematic underreporting. Reports from women are less predictable.

Preliminary Effectiveness of Remotely Monitored Blood Alcohol Concentration Device as Treatment Modality (Preprint)

2021 ◽  
Author(s):  
Frank D. Buono ◽  
Colette M. Greed ◽  
Martin Boldin ◽  
Allison Aviles ◽  
Natalie Wheeler
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Treatment Motivation ◽  
Blood Alcohol ◽  
Limited Effectiveness ◽  
Long Term Treatment ◽  
The Impact

UNSTRUCTURED Alcohol use disorder is a chronic disorder with a high likelihood of relapse. Consistent monitoring of blood alcohol concentration through breathalyzers is critical to identifying relapse or misuse. Smartphone applications as a replacement of, or in conjunction with breathalyzers, have shown limited effectiveness. Therefore, the purpose of this research protocol manuscript is to evaluate the usage and acceptability of a wireless blood alcohol concentration device in collaboration with a long-term treatment facility to assess increased sobriety for patients with alcohol use disorder. The randomized clinical trial will be across two arms, access to the wireless breathalyzer versus no access to the breathalyzer, while both groups have access to treatment. Evaluation will last three months with a six week-follow up, during which each participant will be interviewed at admission, 1 month in, 2 months in, 3 months in and follow-up. Outcomes will focus on the acceptability of the wireless breathalyzer within the alcohol use disorder population and the impact of quality-of-life measures and clinical features on treatment motivation. In addition, we intend to identify the participants’ experiences in relationship to their treatment satisfaction and perceived support.

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