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Alcohol and Risk of Mortality in Patients With Traumatic Brain Injury

Shandro, Jamie R. MD, MPH; Rivara, Frederick P. MD, MPH; Wang, Jin PhD, MS; Jurkovich, Gregory J. MD; Nathens, Avery B. MD, PhD, MPH; MacKenzie, Ellen J. PhD

Journal of Trauma-Injury Infection & Critical Care: June 2009 - Volume 66 - Issue 6 - pp 1584-1590
doi: 10.1097/TA.0b013e318182af96
Original Articles

Background: Laboratory and clinical studies demonstrate inconsistent findings on the effect of alcohol on traumatic brain injury (TBI) outcome. The purpose of this study is to use a comprehensive trauma database to determine whether blood alcohol concentration (BAC) is associated with mortality in patients with TBI.

Methods:

Design: Cohort study.

Setting: Eighteen trauma centers and 51 nontrauma centers in the United States.

Patients: A total of 1,529 patients aged 18 years to 84 years of age admitted to hospital with TBI between July 2001 and November 2002.

Exposure: BAC assessed in the index hospital emergency department.

Outcome: Mortality in-hospital, 90 and 365 days after injury.

Results: After adjusting for confounding variables, there was no significant difference for in-hospital, 90-day, and 365-day mortality by BAC.

Conclusions: When fully adjusted for injury severity, alcohol intoxication is not associated with significantly lower mortality after TBI. The trend toward lower mortality at higher BACs prompts questions about the complex interaction of alcohol and TBI, and warrants further investigation of the possible protective effect of alcohol.

From the Harborview Injury Prevention and Research Center (J.R.S., F.P.R., J.W., G.J.J.), University of Washington School of Medicine, Seattle, Washington; St. Michael’s Hospital (A.B.N.); University of Toronto (A.B.N.), Toronto, Ontario, Canada; and Department of Health Policy and Management (E.J.M.), Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Submitted for publication January 8, 2008.

Accepted for publication June 9, 2008.

Supported by National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention grant R49/CCR316840, and National Institutes on Aging of the National Institutes of Health grant R01/AG20361.

Address for reprints: Jamie R. Shandro, MD, MPH, Harborview Medical Center, 325 9th Avenue, Box 359702, Seattle, WA 98104; email: jshandro@u.washington.edu.

© 2009 Lippincott Williams & Wilkins, Inc.