Alcohol and traumatic brain injury: the understated vector of a silent epidemic
Alcohol and traumatic brain injury: the understated vector of a silent epidemic
Objective: Few studies have analysed the role of alcohol consumption in traumatic brain injury (TBI), with conflicting reports on its effect on outcome. Our aim was to investigate the incidence of alcohol intoxication in our TBI population and its relationship to the severity of injury, intracranial pathology and outcome.
Methods: From the TBI database, demographic, injury and clinical details (including alcohol intoxication) were prospectively recorded for 362 patients aged >16 years and admitted to Neurosurgical ITU between September 2005 and September 2008. Data, including mortality and dichotomized GOS (favourable = 4–5; unfavourable = 1–3) at discharge, 6 and 12 months, were analysed using ?2, t-test and ANOVA after normalisation where appropriate.
Results: Intoxication was present in 36% of patients who were slightly younger (mean 37.6 vs. 40.1 years) and predominantly males (83%vs. 76%) when compared with non-intoxicated. There was no significant difference between these groups in GCS (median 8 vs. 10), length of stay and outcome. At 6 months, 67% had a favourable outcome (71% at 12 months) and mortality was 8.4%. There was a strong association between alcohol and mechanism of injury (p = 0.02), with assaults being significantly more common in this subgroup.
Conclusions: To our knowledge, this is the largest single-centre study on alcohol consumption and TBI. Despite no apparent effect on outcome, intoxication plays a role in over a third of the admissions. Given the disease burden of TBI, this further highlights public health concerns about alcohol in the UK. The focus should perhaps be on the rise in consumption in young people, a group for which TBI remains the largest cause of death and disability.
123-123
Shooman, D.
184d9632-48ea-4f36-8b28-ea1aa1b239e6
Gardner, M.
d3e0b134-870e-49da-b15c-95394d6aa659
Sinclair, J.M.A.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Hell, J.
d70127a0-4b46-4ef1-951b-853e2b349864
Belli, A.
173116e3-a9e8-4ed2-afc4-932f7001eeb0
2009
Shooman, D.
184d9632-48ea-4f36-8b28-ea1aa1b239e6
Gardner, M.
d3e0b134-870e-49da-b15c-95394d6aa659
Sinclair, J.M.A.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Hell, J.
d70127a0-4b46-4ef1-951b-853e2b349864
Belli, A.
173116e3-a9e8-4ed2-afc4-932f7001eeb0
Shooman, D., Gardner, M., Sinclair, J.M.A., Hell, J. and Belli, A.
(2009)
Alcohol and traumatic brain injury: the understated vector of a silent epidemic.
[in special issue: Proceedings of the 153rd Meeting of the Society of British Neurological Surgeons: Oral Abstracts of the Platform Presentations]
British Journal of Neurosurgery, 23 (2), .
(doi:10.1080/02688690902858607).
Abstract
Objective: Few studies have analysed the role of alcohol consumption in traumatic brain injury (TBI), with conflicting reports on its effect on outcome. Our aim was to investigate the incidence of alcohol intoxication in our TBI population and its relationship to the severity of injury, intracranial pathology and outcome.
Methods: From the TBI database, demographic, injury and clinical details (including alcohol intoxication) were prospectively recorded for 362 patients aged >16 years and admitted to Neurosurgical ITU between September 2005 and September 2008. Data, including mortality and dichotomized GOS (favourable = 4–5; unfavourable = 1–3) at discharge, 6 and 12 months, were analysed using ?2, t-test and ANOVA after normalisation where appropriate.
Results: Intoxication was present in 36% of patients who were slightly younger (mean 37.6 vs. 40.1 years) and predominantly males (83%vs. 76%) when compared with non-intoxicated. There was no significant difference between these groups in GCS (median 8 vs. 10), length of stay and outcome. At 6 months, 67% had a favourable outcome (71% at 12 months) and mortality was 8.4%. There was a strong association between alcohol and mechanism of injury (p = 0.02), with assaults being significantly more common in this subgroup.
Conclusions: To our knowledge, this is the largest single-centre study on alcohol consumption and TBI. Despite no apparent effect on outcome, intoxication plays a role in over a third of the admissions. Given the disease burden of TBI, this further highlights public health concerns about alcohol in the UK. The focus should perhaps be on the rise in consumption in young people, a group for which TBI remains the largest cause of death and disability.
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Published date: 2009
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Local EPrints ID: 143515
URI: http://eprints.soton.ac.uk/id/eprint/143515
ISSN: 0268-8697
PURE UUID: 0a6dc68a-aa0d-49c3-a02b-76fca4de6e87
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Date deposited: 12 Apr 2010 10:23
Last modified: 14 Mar 2024 02:40
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Author:
D. Shooman
Author:
M. Gardner
Author:
J. Hell
Author:
A. Belli
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