Alcohol and Musculoskeletal Injury: The effects of alcohol on recovery from fractures and dislocations

Nathan Ford (nateford@ucla.edu)
Primary Care, Charles Drew University and David Geffen School of Medicine at UCLA
October, 2009
 
Nathan Ford, MS IV
Charles Drew University and David Geffen School of Medicine at UCLA
 

Abstract

Alcohol and Musculoskeletal Injury: The effects of alcohol on recovery from fractures and dislocations

Nathan Ford, David E. Fish, Deyu Pen, Shahrzad Bazargan-Hejazi

Background: Chronic alcohol consumption has been shown to exert an inhibitory effect on bone remodeling and fracture healing.
Objectives: To assess the role of alcohol misuse in length of hospital stay, rate of infection, and rate of re-operation amongst patients recovering from fractures and dislocations.
Methods: This was a retrospective analysis of the California Hospital Discharge Data. ICD-9 codes were used to search the California Hospital Discharge Data (1991-2000). These codes were used to identify skeletal fractures and joint dislocations, procedures involving open and closed reduction of fractures, and post-operative infections. For alcohol misuse, patients with ICD-9 codes for abuse or acute intoxication, acute intoxication with dependence, and addiction were included in the study. Various statistical tests including descriptive statistics, chi-square and t-tests, and multivariate analyses were employed to analyze the associations between each predictor and outcome variables.
Results: Alcohol misuse was identified in 3.4% (n=28,013) of our sample. Using multivariate logistic regression we were able to identify a statistically significant relationship between alcohol misuse and each of the outcome variables. Patients diagnosed with an alcohol misuse experienced a significantly greater length of hospital stay (OR 2.20, CI: 2.14-2.26, p=.001), rate of re-operation (OR 1.53, CI: 1.49-1.57 p=.001), and rate of infection (OR 1.99, CI: 1.76-2.25 p=.001) as compared to patients with no alcohol related condition recovering from fractures or dislocations (FDs).
Conclusions: Alcohol misuse may play an inhibitory role in the healing process amongst patients recovering from FDs through increasing the length of hospital stay, rate of re-operation, and rate of infection. In the future we intend to revisit our data set and further break down our analysis to identify upper vs. lower extremity fractures as well as region of limb fractured.



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