2 articles
. Alcohol is a significant modifiable risk factor for severe injuries worldwide. Blood alcohol content measured upon arrival at a trauma center significantly impacts triage accuracy, injury severity assessment, physiological reaction, and clinical outcomes. This systematic review assembles current research concerning the use of blood alcohol content in the triage and care of patients with severe trauma.
. From January 2000 to August 2025, a thorough search of PubMed/MEDLINE, EMBASE, Cochrane Library, Scopus, and Web of Science was conducted. Eligible studies involved adult patients (≥18 years) with severe trauma (Injury Severity Score ≥16 or Abbreviated Injury Scale ≥3), blood alcohol concentration measurements, and documented outcomes related to triage, clinical assessment, or care. Two independent reviewers screened the citations and extracted the information. The Newcastle-Ottawa Scale was used to assess bias. This review was conducted and published in compliance with the PRISMA 2020 guidelines.
. Forty-seven studies met the inclusion criteria, encompassing 1,247,389 trauma patients. The percentage of blood alcohol content-positive patients in trauma hospital settings ranged from 26.2% to 62.5%. A positive blood alcohol content raised the probability of unexpected injuries (OR 4.98; 95% CI 3.62–6.87), being admitted to the intensive care unit (OR 1.87; 95% CI 1.01–3.46), and needing surgery (OR 1.91; 95% CI 1.37–2.66). Upon initial admission, patients who were inebriated scored roughly 1 Glasgow Coma Scale point worse, but they improved over the next 24 hours. This raised concerns regarding triage misclassification. The evidence regarding the neuroprotective impact of alcohol in traumatic brain injury is incongruous: numerous extensive studies have shown reduced adjusted mortality in high blood alcohol content traumatic brain injury patients, while others have shown elevated mortality and an increased risk of coagulopathy. Alcohol has two contradictory impacts on blood clotting: it makes it harder for blood to clot and inhibits the process of breaking down blood clots. It also weakens the body's natural immunological response, increasing susceptibility to post-injury infections.
. Blood alcohol content is a clinically significant triage criterion that underutilized. Systematic blood alcohol content testing should be integrated into international trauma triage guidelines. Trauma teams must not postpone critical neurological interventions while awaiting alcohol metabolism. All major trauma hospitals should standardize alcohol screening and brief intervention programs.
Traumatic brain injury remains a leading global health concern with significant social and economic impact. The main causes include traffic accidents, falls, and violence, especially affecting young adults. In the Republic of Moldova, TBI incidence is rising, particularly during the prehospital phase. TBI involves both primary and secondary brain injuries, the latter often resulting from hypoxia, hypotension, or hyperglycemia. These secondary insults critically influence outcomes and are associated with high mortality. Effective prehospital management – focused on stabilizing oxygenation and hemodynamics – is essential in reducing neurological deterioration. Emergency teams play a key role in preventing secondary injury and improving survival.
This study, conducted from 2020 to 2024, analyzed 486 patients with acute traumatic brain injury (TBI) assessed in both prehospital and emergency department settings. It aimed to evaluate injury severity and prognosis using clinical tools and structured observation forms, developed specifically for this research.
Significant correlations were found between increased age, low systolic blood pressure, prehospital hypoxia, and both TBI severity and mortality (p < 0.0001). While hyperglycemia was not significantly associated with injury severity, it showed a moderate negative correlation with mortality (p < 0.01). Findings emphasize the importance of early monitoring and stabilization of vital signs in the prehospital phase to improve TBI outcomes.
This study emphasizes the importance of systematic prehospital monitoring and management of physiological parameters to mitigate secondary brain injury and improve patient prognosis. Early intervention targeting hypoxia and hypotension remains vital in the acute management of TBI.