Outcomes of elevated blood alcohol concentrations in elderly patients following a ground level fall: A matched analysis from the national trauma quality program

Background

The rising elderly population and the concomitant increase in alcohol consumption can result in a ground level fall (GLF). The purpose of this study is to evaluate the in-hospital mortality, hospital length of stay, and discharge disposition of elderly patients who sustained a ground level fall (GLF) and tested positive for an elevated blood alcohol concentration (BAC).

Methods

The data of patients who were 65 years and older, had an injury after a GLF, and tested for BAC were accessed from the American College of Surgeon – Trauma Quality Improvement Program (ACS-TQIP) from the calendar years of 2011–2016. Patients’ demography, injury, comorbidities, and outcomes were compared between the groups who tested positive (>0.08 g/dL) and negative (0 mg/dL) for BAC. Univariate, followed by matched analyses were performed. All p values are two-sided, and a p value < 0.05 is considered statistically significant.

Results

Out of 20,163 patients who satisfied the inclusion criteria, 2398 patients (∼12%) tested positive for an elevated BAC. There were significant differences found between the two groups, BAC-positive vs. BAC-negative, in univariate analysis for age and sex with p values < 0.001. Propensity score matching balanced demographic characteristics; however, differences remained in certain comorbidities. Exact matching balanced patient demography, injury, and comorbidities. The paired-matched analysis showed no significant differences between the two groups for in-hospital mortality (2.1% vs. 2.1%, p = 1) and median hospital length of stay (5[4–5] vs. 5[5–5], p = 0.307). A higher proportion of patients in the BAC group suffered from alcohol withdrawal syndrome (AWS) and deep vein thrombosis (DVT) complications (9.5% vs. 1.4%, p < 0.001 and 1.5% vs. 0.5%, p = 0.018) compared to BAC-negative patients. A slightly higher percentage of patients in the BAC-positive group were discharged home without any additional services (39.6% vs. 36.9%, p = 0.009).

Conclusion

Of the elderly patients who sustained a GLF and tested for BAC, approximately 12% tested positive for BAC. The overall in-hospital mortality was 2.1%. The BAC-positive group suffered from higher complications of AWS and DVT, and more than 60% of patients required additional services at the time of discharge.