ArticleInternational journal of emergency medicine2026
Alcohol-positive polytrauma patients: injury patterns, ICU resource use and mortality at a German Level I trauma center.
Article in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn most countries, alcohol consumption is so culturally ingrained that even small amounts are permitted while driving. Even at a blood alcohol concentration of 0.5 g/L, ethanol impairs mental and cognitive performance. Studies from the US and Europe estimate that elevated blood alcohol levels may be detected in 10%-40% of all emergency department patients. Against this background, we investigated the impact of alcohol consumption on injury severity, injury patterns, as well as primary and secondary outcomes in polytrauma patients. MATERIALS AND
methodsThis retrospective, single-center cohort study included patients admitted to a Level I trauma center via the trauma room and documented in the TraumaRegister DGU
resultsA total of 1,524 patients were analyzed: 431 (28.3%) were alcohol-positive (ALC) and 1,093 (71.7%) were not (noALC). ALC patients were younger, more often male and had a lower prehospital Glasgow Coma Scale (GCS) score (p < 0.001), whereas the ISS did not differ (p = 0.396). They were more frequently victims of violent crime and were overrepresented among pedestrians and falls from < 3 m, whereas motorcyclists were more often sober. Alcohol-positive patients were more often treated in the ICU (90.0% vs. 86.3%; p = 0.048), but this association was attenuated after multivariable adjustment (adjusted odds ratio [aOR] 1.40; 95% CI 0.96-2.03). Length of ICU stay and duration of mechanical ventilation did not differ, and alcohol was not independently associated with mortality (aOR 0.91; 95% CI 0.56-1.47). Severe TBI was more frequent in alcohol-positive patients (38.5% vs. 29.5%), increased with serum ethanol concentration, and was the strongest predictor of ICU treatment and mortality.
conclusionNearly one in three severely injured patients had detectable serum ethanol. After adjustment for confounders, alcohol was not independently associated with mortality or intensive care resource use, and no dose-response relationship was found for these outcomes. The more frequent ICU treatment of alcohol-positive patients appears to be explained by their distinct injury pattern, particularly the concentration-dependent increase in severe TBI.
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