Alcohol Use Disorder Increases Risk of Traumatic Brain Injury-Related Hospitalization: Insights From 3.8 Million Children and Adolescent Inpatients

Abstract

We conducted a cross-sectional study to identify the demographic predictors of traumatic brain injury (TBI), and the risk of association of psychiatric comorbidities including alcohol use disorder (AUD) and TBI-related hospitalizations in the children and adolescent population. Methods We included 3,825,523 children and adolescent inpatients (age 8-18 years) using the nationwide inpatient sample (NIS) database (2010-2014), and 61,948 inpatients had a primary diagnosis of TBI. These inpatients were grouped by comorbid AUD (N = 2,644). Multivariable logistic regression model adjusted for demographics, and psychiatric comorbidities including other substance use disorders (SUDs) was used to evaluate the odds ratio (OR) of AUD as a risk factor for TBI-related hospitalization. Results The majority of the TBI inpatients were adolescents (12-18 years, 82.2%), males (71.2%), and whites (59.2%). Males had three times higher odds (95% CI 3.14-3.26) for TBI-related hospitalization compared to females. Among psychiatric comorbidities, mood (4.1%) and anxiety (2.2%) disorders were prevalent in TBI inpatients, and were not associated with increased odds for TBI-related hospitalization. Among SUD, alcohol and tobacco use (4.4% each), and cannabis use (3.5%) were prevalent, and among all substances, AUD was associated with higher odds (OR 3.5, 95% CI 3.35-3.67) of TBI-related hospitalization. These patients with TBI and comorbid AUD also had higher odds for abusing stimulants (OR 5.11, 95% CI 3.85-6.77), cannabis (OR 4.69, 95% CI 4.12-5.34), and tobacco (OR 3.77, 95% CI 3.34-4.27). Conclusion AUD is an independent risk factor for TBI-related hospitalization with an increased risk of 50% in the children and adolescent population compared to non-alcohol users. TBI inpatients with AUD are prevalent in white, and male adolescents. These at-risk populations are also at higher risk of comorbid mood disorders and increased substance use including stimulants, cannabis, and tobacco.

Alcohol use in Macau Secondary School Students and relating family factors

“…(13), it is also related to traffic accidents (14). Study has shown that the rate of traumatic brain injury leading to hospitalization is 50% more in child and adolescents who are current drinker compared to non-drinker (15). In this case, our results of rising trend in the rate of current drinker and binge drinker in the adolescents should be given serious attention.…”

Intimate partner violence, substance use, and health comorbidities among women: A narrative review

“…In the general population, the neural changes and resulting cognitive and psychological impairments occurring after TBI are strong predictors of substance use, misuse, and development of SUD (Graham and Cardon, 2008;Weil et al, 2016;Beaulieu-Bonneau et al, 2018;Olsen and Corrigan, 2021), and contribute to poorer treatment outcomes (Corrigan and Deutschle, 2008;Graham and Cardon, 2008). However, the cause-and-effect relationship between TBI and substance use is complex and hard to parse as substance use is both a risk factor for, and sequelae of, TBI (Nikoo et al, 2017;Eskander et al, 2020). Nonetheless, there is evidence that brain injury often remains undiagnosed among IPV-EW, as substance misuse and mental health issues mask brain injury symptoms, thereby precluding effective assessment and treatment for brain injury (Banks, 2007;Haag et al, 2022).…”

Neuroethics across the Disorders of Consciousness Care Continuum

“…The Centers for Disease Control and Prevention (CDC) and numerous research groups have identified populations at higher risk of sustaining severe brain injury in the United States, including racial and ethnic minorities, 9 10 those with psychiatric disorders, 11 12 13 substance use disorders, 14 15 16 military service members and veterans, 17 18 19 20 21 people who are undomiciled, 22 23 24 living in correctional or detention facilities, 25 26 27 refugees, 26 28 and victims of domestic violence. 29 30 31 32 As we will later explore, people who live in rural areas or who are underinsured are less likely to receive appropriate or timely services following brain injury.…”