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Emergency Medicine Journal : EMJ logoLink to Emergency Medicine Journal : EMJ
. 2004 Mar;21(2):185–188. doi: 10.1136/emj.2003.006130

Alcohol related falls: an interesting pattern of injuries

J Johnston 1, S McGovern 1
PMCID: PMC1726307  PMID: 14988344

Abstract

Objective: To discover if there is a significant difference in the pattern and severity of injury sustained during falls in patients who have consumed alcohol and those who have not. To determine how pattern and severity of injury correlates with blood alcohol concentration.

Method: A prospective quasi-randomised controlled study between November 2001 and July 2002. All healthy adults between 16 and 60 years who had fallen from standing height were included. A systematic history and examination permitted calculation of injury severity scores as per abbreviated injury scale update 1998. Blood alcohol concentrations were obtained from intoxicated patients with consent.

Results: 351 healthy adult patients were included in the study, there were 238 in the no alcohol group, 113 had consumed alcohol and blood alcohol intake were obtained for 47. The alcohol group had a higher incidence of head injuries (46 (48%) versus 22 (9%)) with a lower incidence of limb injuries (39 (39%) versus 183 (76%)) than the no alcohol group. There was a significant difference in the pattern of injury between the alcohol and no alcohol groups (χ2, p<0.001) and there was a significant difference in the injury severity scores (p<0.001, Z = -2.5). In the alcohol group severity and pattern correlated with alcohol concentration at the time of injury. Patients with an alcohol concentration<2 g/l had mostly soft tissue limb injuries (58%), 2–2.5 mostly significant limb fractures (55%), and >2.5 mostly significant head injuries (90%).

Conclusions: Alcohol related falls are more often associated with severe craniofacial injury. The severity of both limb and head injury is greater and correlates directly with blood alcohol concentration.

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Selected References

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  1. Biros M. H., Kukielka D., Sutton R. L., Rockswold G. L., Bergman T. A. The effects of acute and chronic alcohol ingestion on outcome following multiple episodes of mild traumatic brain injury in rats. Acad Emerg Med. 1999 Nov;6(11):1088–1097. doi: 10.1111/j.1553-2712.1999.tb00109.x. [DOI] [PubMed] [Google Scholar]
  2. Bombardier C. H., Thurber C. A. Blood alcohol level and early cognitive status after traumatic brain injury. Brain Inj. 1998 Sep;12(9):725–734. doi: 10.1080/026990598122124. [DOI] [PubMed] [Google Scholar]
  3. Cook L. S., Levitt M. A., Simon B., Williams V. L. Identification of ethanol-intoxicated patients with minor head trauma requiring computed tomography scans. Acad Emerg Med. 1994 May-Jun;1(3):227–234. doi: 10.1111/j.1553-2712.1994.tb02436.x. [DOI] [PubMed] [Google Scholar]
  4. Hingson R., Howland J. Alcohol and non-traffic unintended injuries. Addiction. 1993 Jul;88(7):877–883. doi: 10.1111/j.1360-0443.1993.tb02105.x. [DOI] [PubMed] [Google Scholar]
  5. Honkanen R., Smith G. S. Impact of acute alcohol intoxication on the severity of injury: a cause-specific analysis of non-fatal trauma. Injury. 1990 Nov;21(6):353–357. doi: 10.1016/0020-1383(90)90117-d. [DOI] [PubMed] [Google Scholar]
  6. Honkanen R., Visuri T. Blood alcohol levels in a series of injured patients with special reference to accident and type of injury. Ann Chir Gynaecol. 1976;65(4):287–294. [PubMed] [Google Scholar]
  7. Janis L. S., Hoane M. R., Conde D., Fulop Z., Stein D. G. Acute ethanol administration reduces the cognitive deficits associated with traumatic brain injury in rats. J Neurotrauma. 1998 Feb;15(2):105–115. doi: 10.1089/neu.1998.15.105. [DOI] [PubMed] [Google Scholar]
  8. Kelly D. F., Lee S. M., Pinanong P. A., Hovda D. A. Paradoxical effects of acute ethanolism in experimental brain injury. J Neurosurg. 1997 May;86(5):876–882. doi: 10.3171/jns.1997.86.5.0876. [DOI] [PubMed] [Google Scholar]
  9. Roys M. S. Serious stair injuries can be prevented by improved stair design. Appl Ergon. 2001 Apr;32(2):135–139. doi: 10.1016/s0003-6870(00)00049-1. [DOI] [PubMed] [Google Scholar]
  10. Servadei F., Teasdale G., Merry G., Neurotraumatology Committee of the World Federation of Neurosurgical Societies Defining acute mild head injury in adults: a proposal based on prognostic factors, diagnosis, and management. J Neurotrauma. 2001 Jul;18(7):657–664. doi: 10.1089/089771501750357609. [DOI] [PubMed] [Google Scholar]
  11. Tate P. S., Freed D. M., Bombardier C. H., Harter S. L., Brinkman S. Traumatic brain injury: influence of blood alcohol level on post-acute cognitive function. Brain Inj. 1999 Oct;13(10):767–784. doi: 10.1080/026990599121160. [DOI] [PubMed] [Google Scholar]
  12. Zink B. J., Stern S. A., Wang X., Chudnofsky C. C. Effects of ethanol in an experimental model of combined traumatic brain injury and hemorrhagic shock. Acad Emerg Med. 1998 Jan;5(1):9–17. doi: 10.1111/j.1553-2712.1998.tb02568.x. [DOI] [PubMed] [Google Scholar]

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