Research Reports - Effect of alcohol in traumatic brain injury

J Surg Res. 2014 May 1

Pandit V(1), Patel N(1), Rhee P(1), Kulvatunyou N(1), Aziz H(1), Green DJ(1), O'Keeffe T(1), Zangbar B(1), Tang A(1), Gries L(1), Friese RS(1), Joseph B(2)

BACKGROUND: Studies have proposed a neuroprotective role for alcohol (ETOH) in
traumatic brain injury (TBI). We hypothesized that ETOH intoxication is
associated with mortality in patients with severe TBI.
METHODS: Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for
all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4)
and blood ETOH levels recorded on admission. Primary outcome measure was
mortality. Multivariate logistic regression analysis was performed to assess
factors predicting mortality and in-hospital complications.
RESULTS: A total of 23,983 patients with severe TBI were evaluated of which 22.8%
(n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients
were more likely to have in-hospital complications (P = 0.001) and have a higher
mortality rate (P = 0.01). ETOH intoxication was an independent predictor for
mortality (odds ratio: 1.2, 95% confidence interval: 1.1-2.1, P = 0.01) and
development of in-hospital complications (odds ratio: 1.3, 95% confidence
interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI.
CONCLUSIONS: ETOH intoxication is an independent predictor for mortality in
patients with severe TBI patients and is associated with higher complication
rates. Our results from the National Trauma Data Standards differ from those
previously reported. The proposed neuroprotective role of ETOH needs further
clarification.

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