Monday, June 15, 2015

For Binge Drinkers, Relatively Minor Burns Can Lead to Serious Complications, Long Hospital Stays

MAYWOOD, Ill. -- A Loyola University Medical Center study has found that binge drinking may slow recovery and increase medical costs for survivors of burn injuries. The study was presented during the 44th Annual Meeting of the American Burn Association in Seattle.

Loyola researchers compared burn patients who were intoxicated above the legal limit with burn patients who had no alcohol in their blood. Although the binge drinkers' injuries were much less severe than those of other patients admitted to Loyola's Burn Unit, the binge drinkers experienced similar rates of sepsis and pneumonia and spent similar amounts of time on the ventilator, in the ICU and in the hospital.

The hospital bill for burn-injured binge drinkers was a median of $221,000, which was nearly as high as the bill for nondrinkers with much more serious burns.
"Among binge drinkers, even relatively minor injuries can result in serious complications and prolonged hospital stays," said senior author Elizabeth J. Kovacs, PhD, director of research of the Burn & Shock Trauma Institute of Loyola University Chicago Stritch School of Medicine and director of Loyola's Alcohol Research Program.

Kovacs and colleagues followed 53 patients who came to Loyola with inhalation injuries. Twelve patients had blood-alcohol levels greater than 0.08 percent, the legal limit for driving. Four patients had lower blood-alcohol counts and 37 patients had no alcohol in their blood. The finding that 30 percent of burn patients had been drinking is similar to findings of earlier studies.
On average, nondrinkers were burned over 24.9 percent of their bodies, compared with only 10.6 percent in binge drinkers.

"We suspect the reason binge drinkers have smaller burns is because those with more severe injuries were unable to escape due to their intoxication," said Christopher S. Davis, MD, MPH, first author of the study.

Davis said there are three likely reasons why binge drinkers experienced such difficult recoveries, despite their relatively minor injuries:

Intoxication weakens the immune system at a critical time, slowing the healing process and making patients more prone to infections.

While hospitalized, chronic alcohol abusers go through withdrawal. Consequently, they may become agitated and uncooperative -- by, for example, removing a breathing tube or not participating in rehabilitation.

Carbon monoxide poisoning levels in binge drinkers were more than four times higher than levels in nondrinkers, probably because it took binge drinkers longer to escape. Carbon monoxide poisoning can cause brain damage and other effects that complicate recovery.

Researchers wrote that their findings "affirm the impact of alcohol intoxication at the time of burn and smoke inhalation injury, placing renewed emphasis on injury prevention and alcohol abuse education."

Other authors are Thomas J. Esposito, MD, MPH, FACS; Anna G. Palladino-Davis, MS, MPH; Karen Rychlik, MS; and Richard L. Gamelli, MD, FACS. Gamelli is director of the Burn and Shock Trauma Institute.

The authors acknowledged Carol R. Schermer, MD, MPH, for reviewing the manuscript and the nursing and support staff in Loyola's Burn Intensive Care Unit.

The study was funded by the National Institutes of Health, Department of Defense and the Dr. Ralph and Marian C. Falk Medical Research Trust.

About Loyola University Health System

Loyola University Health System (LUHS) is part of Trinity Health. Based in the western suburbs of Chicago, LUHS is a quaternary care system with a 61-acre main medical center campus, the 36-acre Gottlieb Memorial Hospital campus and more than 30 primary and specialty care facilities in Cook, Will and DuPage counties. Loyola University Medical Center’s campus is conveniently located in Maywood, 13 miles west of Chicago’s Loop and 8 miles east of Oak Brook, Ill. At the heart of the medical center campus is a 559-licensed-bed hospital that houses a Level 1 Trauma Center, a Burn Center and the Ronald McDonald® Children's Hospital of Loyola University Medical Center. Also on campus are the Cardinal Bernardin Cancer Center, Loyola Outpatient Center, Center for Heart & Vascular Medicine and Loyola Oral Health Center as well as Loyola University Chicago Stritch School of Medicine, Loyola University Chicago Marcella Niehoff School of Nursing and the Loyola Center for Fitness. Loyola's Gottlieb campus in Melrose Park includes the 255-licensed-bed community hospital, the Professional Office Building housing 150 private practice clinics, the Adult Day Care, the Gottlieb Center for Fitness, Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park.

Trinity Health is a national Catholic health system with an enduring legacy and a steadfast mission to be a transforming and healing presence within the communities we serve. Trinity is committed to being a people-centered health care system that enables better health, better care and lower costs. Trinity Health has 88 hospitals and hundreds of continuing care facilities, home care agencies and outpatient centers in 21 states and 119,000 employees.