Examining the influence of blood alcohol level on the incidence of pneumonia & sepsis complications following traumatic injury

Background: The purpose of this study was to examine the impact of blood alcohol concentration (BAC) on the occurrence of pneumonia and sepsis among traumatic injury victims. Methods: Retrospective study data were retrieved from the 2007–2010 National Trauma Data Bank and included all patients ≥14 years of age, with a “blunt” or “penetrating” injury, who were taken to a level 1 or level 2 trauma center, had complete systolic blood pressure and heart rate records, and had a confirmed blood alcohol test at the time of hospital arrival. Patients' characteristics and outcome information were compared between two groups (those with a BAC above the legal limit [>0.08 g/dL] and those with a negative BAC result), followed by propensity score matching and a follow-up paired analysis. Results: Of 279,460 patients, 92,960 tested positive for alcohol with a BAC above the legal limit. There were clear demographic differences between the groups (p < 0.001). Therefore, propensity score matching was performed to better balance the groups and the resulting standardized mean differences of less than 10% indicated successful matching. When comparing the occurrence of both pneumonia and sepsis between the matched pairs, there was a statistically significantly higher rate of pneumonia in the alcohol positive patients, 8.0% vs. 7.3%, (p = 0.03), but no significant clinical difference. Additionally, no significant difference was observed for the rate of sepsis across the groups (p = 0.62). Conclusion: Patients who tested positive for alcohol following a traumatic injury showed a statistically higher incidence of pneumonia, but there was no clinically significant difference. Additionally, there was no significant difference identified in the incidence of sepsis between the BAC groups.