Adolescent trauma and alcohol: increased risk for severe head injury and organ dysfunction-insights from the TraumaRegister DGU®.

PURPOSE: Alcohol consumption is common among young individuals and is a significant, yet preventable, risk factor for injuries and fatalities. In adults, it influences injury patterns, severity, and potentially outcomes via immunomodulatory effects. However, data in adolescents are scarce. This study seeks to address this deficiency by analyzing data from the TraumaRegister DGU® (TR-DGU) to investigate the impact of alcohol on adolescent trauma patients.

METHODS

This retrospective TR-DGU analysis included trauma patients aged 10-20 years admitted between 2015 and 2019. Patients were stratified by blood alcohol level (BAL positive vs. negative) and analyzed for demographics, injury patterns, prehospital characteristics, and in-hospital outcomes, including ICU length of stay (LOS), organ failure, and mortality.

RESULTS

Of 1,823 patients, 1,481 were BAL- and 324 BAL+. Alcohol-positive incidence increased over the study period, particularly in older adolescents, and was more frequent in winter, on weekends, and at night. BAL + patients were more often involved in violent and penetrating trauma and sustained more severe head injuries (43.6% vs. 36.5%, p = 0.016) but were intubated less often (30.8% vs. 34.5%, p = 0.099), significantly so in the 18-20-year group. BAL + adolescents had higher rates of respiratory organ failure (15.2% vs. 8.3%, p = 0.014) and sepsis (5.9% vs. 2.8%, p = 0.03), with no significant differences in ICU LOS or mortality.

CONCLUSION

Alcohol use remains a significant factor among adolescent trauma patients in German-speaking countries. As trauma mechanisms vary by age, targeted prevention strategies are crucial. Intoxicated adolescent trauma patients form a high-risk group requiring special attention. Further research into alcohol's immunomodulatory effects in this population is essential to improve trauma care strategies.