ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2021
Do not drink and lyse: alcohol intoxication increases fibrinolysis shutdown in injured patients.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Acute intoxication and trauma severity in emergency department patients: a systematic review.BMC emergency medicine · 2026Pooled it
- Neurologic Improvement in Acute Cerebral Ischemia: Frequency, Magnitude, Predictors, and Clinical Outcomes.Neurology · 2023Trial
- Adolescent trauma and alcohol: increased risk for severe head injury and organ dysfunction-insights from the TraumaRegister DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Construction of a nomogram model for predicting delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage patients.Scientific reports · 2025Article
- Effect of alcohol abuse on selected markers of inflammation, hemostasis, and endothelial function.Cardiology journal · 2024Article
- Focus on biomarkers, confounders and new therapeutic approaches in trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Effect of acute alcohol intoxication on mortality, coagulation, and fibrinolysis in trauma patients.PloS one · 2021Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
introductionHigh alcohol consumption has been associated with decreased fibrinolysis and enhanced thrombosis risk in cardiovascular disease. In trauma, alcohol has been associated with poor clot formation; however, its effect on fibrinolysis has not been fully investigated. We assessed the association of blood alcohol levels and fibrinolysis in trauma activation patients.
methodsWe queried our prospective registry of trauma activations from 2014 to 2016. Associations between viscoelastic measurements [rapid thrombelastography (rTEG)] and blood alcohol level (BAL) were determined and adjusted for confounders by a multinomial logistic regression. Lysis phenotypes were defined by the % lysis in 30 min (LY30) as follows: hyperfibrinolysis ≥ 3%, physiologic 0.9-2.9%, and fibrinolysis shutdown < 0.9%.
resultsOverall, 191 (43.8%) had BAL measured. There were 65 (34%) patients that had no detectable BAL, 32 (16.8%) had BAL of 10-150 mg/dL, and 94 (49.2%) patients had BAL > 150 mg/dL. BAL had a moderate, but significant inverse correlation with LY30 (Rho = - 0.315, p < 0.001), while there were no significant correlations between BAL and other TEG values. The distribution of fibrinolysis phenotypes varied significantly by BAL levels (p < 0.009, with high BAL having more shutdown and less hyperfibrinolysis than the other two BAL level groups. Multinomial logistic regression showed that after adjustment for confounders, BAL levels > 150 mg/dL were independently associated with a threefold increase in the odds of shutdown compared to undetectable BAL (OR 3.37, 95% CI 1.04-8.05, p = 0.006). High BAL was also significantly associated with higher odds of shutdown compared to low BAL (OR 2.63, 95% CI 1.15-6.06). Compared to physiologic fibrinolysis, fibrinolysis shutdown was associated with increased mortality (OR 2.87, 95% CI 1.41-5.83) and VFD < 28 (OR 2.54, 95% CI 1.47-4.39).
conclusionIn the injured patient, high blood alcohol levels are associated with increased incidence of fibrinolysis shutdown. This finding has implications for postinjury hemostatic resuscitation as these patients may be harmed by anti-fibrinolytics. Further research is needed to assess whether the association with fibrinolysis is modified by the chronicity and type of alcohol consumed and whether anti-fibrinolytic therapy in intoxicated patients produces adverse effects.
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