Alcohol exposure appears to increase mortality after injury

From the European Journal of Trauma and Emergency Surgery:

Objective: To determine the injury patterns, complications, and mortality after alcohol consumption in trauma patients.

Methods: The Trauma Registry at an American College of Surgeons (ACS) level I center was queried for all patients with a toxicology screen admitted between 1st January 2002 and 31st December 2005. Alcohol-positive (AP) patients were matched to control patients who had a completely negative screen (AN) using age, gender, mechanism, Injury Severity Score (ISS), head Abbreviated Injury Scale (AIS), chest AIS, abdominal AIS, and extremity AIS. Injuries and outcomes were compared between the groups.

Results: As many as 5,317 patients had toxicology data, of which 471 (8.9%) had a positive alcohol screen (AP). A total of 386 AP patients were then matched to 386 control (AN) patients. The AP group had a significantly higher mortality than the AN group overall (23 vs. 13%; p < 0.001), and by ISS stratification: ISS < 16 (6 vs. 0.4%; p < 0.001), ISS 16–25 (53 vs. 28%; p = 0.01), and ISS > 25 (90 vs. 67%; p = 0.01). AP patients had a higher incidence of admission systolic blood pressure < 90 (18 vs. 10%; p < 0.001) and Glasgow Coma Scale (GCS) score ≤ 8 (25 vs. 17%; p = 0.002). AN patients had a significantly higher incidence of hemopneumothorax (11 vs. 7%; p = 0.03), while AP patients had a higher incidence of cardiac arrest (8 vs. 3%; p = 0.004). There was no difference in intensive care unit (ICU) and hospital length of stay.

Conclusion: In a mixed population of trauma patients, an AP screen is associated with an increased incidence of admission hypotension and depressed GCS score. In this case-matched study, alcohol exposure appeared to increase mortality after injury.

Medical Device Problems Hurt 70,000+ Kids Annually

From NPR:

More than 70,000 children and teens go to the emergency room each year for injuries and complications from medical devices, and contact lenses are the leading culprit, the first detailed national estimate suggests.

About one-fourth of the problems were things like infections and eye abrasions in contact lens wearers. These are sometimes preventable and can result from wearing contact lenses too long without cleaning them.

Other common problems found by researchers at the U.S. Food and Drug Administration include puncture wounds from hypodermic needles breaking off in the skin while injecting medicine or illegal drugs; infections in young children with ear tubes; and skin tears from pelvic devices used during gynecological exams in teen girls.

IRS Refunds $20M to Resident Physicians and Hospital

From Modern Healthcare:

Nearly 1,000 former medical residents and a Cincinnati hospital will split $20 million in refunds from the Internal Revenue Service.

The IRS says stipends paid to former residents from 1997 to 2005 weren’t subject to Social Security taxes because the residents were students.

An attorney for University Hospital in Cincinnati says the refunds will total $20 million. The former residents will get half.

Students are usually exempt from taxes that fund Social Security and Medicare. The IRS conceded earlier this year that it collected taxes from medical residents and their employers on wages that should have been exempt.