Alcohol ingestion is independently associated with complications after work place injuries: A National Trauma Data Bank analysis of injury severity and outcomes

Background: Work place injuries have socioeconomic and workforce health implications. Results of clinical studies on the effect of alcohol (ETOH) ingestion on short-term outcomes in trauma are varied. We performed this study to estimate the prevalence of ETOH-related injury in the workplace and its relevance to outcomes. Methods: Using the National Trauma Data Bank v. 7.0, incident codes identified as being work related were extracted. The study group comprised those work-related injury cases wherein an ETOH result was documented. The ETOH (+) group was compared with the ETOH (-) group with respect to injury mechanism, injury severity, complications, and mortality. Logistic regression analysis was used to determine independent associations with these outcomes. Results: There were 31,028 cases who met inclusion criteria. Overall mortality was 2.9% (909, odds ratio [95% confidence interval], p-value) while complication rate was 2.9% (911). The incidence of a ETOH (+) screen was 10.8% (3356). Mortality in the ETOH (+) group was 3.5% (117) versus 2.9% (792) in the ETOH (-) group. This was not significantly different on logistic regression (0.88 [0.69-1.12], 0.30). The overall complication rate in the ETOH (+) group was 5.9% (197) versus 2.6% (714) in the ETOH (-) group (2.27 [1.95-2.65], <0.01). In particular, infectious complications (on post hoc analysis) were significantly increased in the ETOH (+) group (3.7% [125] vs. 1.4% [381]; 2.71 [2.22-3.30], <0.01). On logistic regression analysis, an ETOH (+) screen was not independently associated with death; however, a (+) screen was independently associated with complications. Conclusions: The incidence of ETOH-associated workplace injury is potentially significant. Despite variable effects of ETOH ingestion on trauma outcomes, the presence of a ETOH (+) screen is independently associated with complications after occupational injury.