Every Thursday, Laboratory Equipment features a Scientist of the Week, chosen from the science industry’s latest headlines. This week’s scientist is Lee Friedman from the Univ. of Illinois at Chicago School of Public Health. He and a team found that injured patients were less likely to die in the hospital if they had alcohol in their blood.
Q: What made you interested in studying how intoxication impacted mortality rates after injury?
A: I have been actively involved in injury epidemiology for over 15 years. In this field of research, one cannot investigate injury risks without considering the role of alcohol and other substances known to increase an individual’s risk of injury. My main goal as a researcher is to explore the factors that increase the risk of injury as well as those factors that reduce mortality and impairment following an injury.
Q: What are the future implications of your research and findings?
A: Ideally, the next step is to investigate and better understand the biomechanism behind this association in order to develop a sound treatment protocol for appropriate patients in order to reduce mortality following an injury. Alcohol may not be the best treatment considering the large segments of the population that are unable to metabolize ethanol efficiently and other subgroups of patients that may actually have adverse reactions to ethanol treatment. Alternative substances that mimic the specific beneficial effects of ethanol would likely be the safer approach.
Q: What was the most surprising thing you found in your research?
A: Everything about the study was surprising. In fact, at first I thought it was an artifact. However, the more I investigated the association, the strength and direction of the relationship between blood alcohol concentration and in-hospital mortality was consistent across sensitivity models and important injury subgroups.
Q: What is the take home message of your research and results?
A: Blood alcohol concentration is strongly associated with a reduction in in-hospital mortality following an injury. Overall, the in-hospital mortality rate in Illinois hospitals is quite low among injured patients – two to four percent, but alcohol at the highest blood levels was associated with a reduction of up to 50 percent in mortality. Injury is the number one killer in the U.S. among persons under the age of 40 years – approximately 200,000 deaths per year. A finding of this magnitude could potentially have a major impact on thousands of lives.
Q: What is next for you and your research?
A: I am currently working on a follow-up study to look at possible medical complications following an injury that may be less prevalent in those with measured blood alcohol concentrations. Based on my preliminary findings, it appears that that alcohol reduces the risk of renal failure and myocardial complications including infarctions, heart failure, fibrillations and severe arrhythmias. This actually makes sense considering what we know about the physiological mechanisms of alcohol. Alcohol impacts the body in various ways including increasing release of catecholamines, effects smooth muscles, increases myocardial contractility, increases energy yield, increases cell membrane viscosity and potentiates the effects of many other drugs, including those commonly used in the treatment of injured patients. Based on physiological studies on the biomechanism of alcohol, it makes sense that alcohol would “keep blood flow pumping” (myocardial contractility, catecholamines), and maintain arterial/venal integrity and reduce risk of infarctions. Renal failure is caused by an array of factors, but prerenal causes include heart failure or reduced cardiac output. So this would tie back to the cardiac effects of alcohol. In all likelihood, because of the complex and varied effects of alcohol on the human body, the explanation is probably more complex than what is described above, and there are probably some effects from alcohol which may actually increase one’s risk of death. But the overall net impact appears to be that alcohol is protective following an injury.