Shock. 2021 Mar 23. doi: 10.1097/SHK.0000000000001782. Online ahead of print.
ABSTRACT
BACKGROUND: The base excess (BE) parameter can be used as an indicator of mortality. However, study results on the influence of alcohol on the validity of BE as a prognostic parameter in alcohol-intoxicated patients are controversial. Thus, this study examined the hypothesis: An increasing blood alcohol level reduces the prognostic value of the Base Excess parameter on mortality.
MATERIAL METHODS: In a retrospective analysis of the multi-centre database of the TraumaRegister DGU®, patients from 2015 to 2017 were grouped depending on their blood alcohol level (BAL) into a BAL+ and BAL- group. The hypothesis was verified using logistic regression with an assumed significance level of 1% (p < 0.01).
RESULTS: 11889 patients were included; 9472 patients in the BAL- group and 2417 patients in the BAL+ group. Analysis of the BE showed lower values in the BAL+ group (BAL-: -1.8 ± 4.4 mmol/l vs. BAL+: -3.4 ± 4.6 mmol/l). There is a trend towards lower BE levels when BAL increases. Assuming a linear relationship, then BE decreases by 0.6 points per mille alcohol (95%CI: 0.5-0.7; p < 0.001). The mortality rate was significantly lower in the BAL+ group (BAL-: 11.1% vs. BAL+: 7.9%). The logistic regression analysis showed a significant beneficial influence of BAL+ on the mortality rate (OR 0.706, 95% CI 0.530 – 0.941, p = 0.018). To analyse whether a low BE (≤ -6 mmol/l) has different prognostic effects in patients with and without alcohol, logistic regression models were calculated. However, the effect of BE ≤ -6 mmol/l was similar in both models (regression coefficients in BAL-/+ patients: 0.379 / 0.393).
CONCLUSIONS: The data demonstrate an existing influence of alcohol on the BE parameter; however, this does not negatively affect the BE as a prognostic parameter at a threshold of ≤ -6 mmol/l.
PMID:33756506 | DOI:10.1097/SHK.0000000000001782
