About: Do not drink and lyse: alcohol intoxication increases fibrinolysis shutdown in injured patients

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Do not drink and lyse: alcohol intoxication increases fibrinolysis shutdown in injured patients
Creator	Christopher, · Moore, B Banerjee, · Moore, Ernest Silliman, C »more»
source	PMC
abstract	INTRODUCTION: High alcohol consumption has been associated with decreased fibrinolysis and enhanced thrombosis risk in cardiovascular disease. In trauma, alcohol has been associated with poor clot formation; however, its effect on fibrinolysis has not been fully investigated. We assessed the association of blood alcohol levels and fibrinolysis in trauma activation patients. METHODS: We queried our prospective registry of trauma activations from 2014 to 2016. Associations between viscoelastic measurements [rapid thrombelastography (rTEG)] and blood alcohol level (BAL) were determined and adjusted for confounders by a multinomial logistic regression. Lysis phenotypes were defined by the % lysis in 30 min (LY30) as follows: hyperfibrinolysis ≥ 3%, physiologic 0.9–2.9%, and fibrinolysis shutdown < 0.9%. RESULTS: Overall, 191 (43.8%) had BAL measured. There were 65 (34%) patients that had no detectable BAL, 32 (16.8%) had BAL of 10–150 mg/dL, and 94 (49.2%) patients had BAL > 150 mg/dL. BAL had a moderate, but significant inverse correlation with LY30 (Rho = − 0.315, p < 0.001), while there were no significant correlations between BAL and other TEG values. The distribution of fibrinolysis phenotypes varied significantly by BAL levels (p < 0.009, with high BAL having more shutdown and less hyperfibrinolysis than the other two BAL level groups. Multinomial logistic regression showed that after adjustment for confounders, BAL levels > 150 mg/dL were independently associated with a threefold increase in the odds of shutdown compared to undetectable BAL (OR 3.37, 95% CI 1.04–8.05, p = 0.006). High BAL was also significantly associated with higher odds of shutdown compared to low BAL (OR 2.63, 95% CI 1.15–6.06). Compared to physiologic fibrinolysis, fibrinolysis shutdown was associated with increased mortality (OR 2.87, 95% CI 1.41–5.83) and VFD < 28 (OR 2.54, 95% CI 1.47–4.39). CONCLUSION: In the injured patient, high blood alcohol levels are associated with increased incidence of fibrinolysis shutdown. This finding has implications for postinjury hemostatic resuscitation as these patients may be harmed by anti-fibrinolytics. Further research is needed to assess whether the association with fibrinolysis is modified by the chronicity and type of alcohol consumed and whether anti-fibrinolytic therapy in intoxicated patients produces adverse effects.
has issue date	2020-03-10(xsd:dateTime)
bibo:doi	10.1007/s00068-020-01328-x
bibo:pmid	32157340
has license	no-cc
sha1sum (hex)	23fdf1a7d80f48aa82e9ab5e8a0554c6603c4f36
schema:url	https://doi.org/10.1007/s00068-020-01328-x
resource representing a document's title	Do not drink and lyse: alcohol intoxication increases fibrinolysis shutdown in injured patients
has PubMed Central identifier	PMC7222146
has PubMed identifier	32157340
schema:publication	Eur J Trauma Emerg Surg
resource representing a document's body	covid:23fdf1a7d80f48aa82e9ab5e8a0554c6603c4f36#body_text
is schema:about of	named entity 'blood alcohol levels' named entity 'Multinomial logistic regression' named entity 'correlation' named entity 'VFD' named entity 'High' »more»

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