Early outcome in patients with traumatic brain injury, pre-injury alcohol abuse and intoxication at time of injury

Abstract

Despite a longer PTA and LOS, global and neurobehavioural outcomes at discharge from acute care were not different for those with pre-injury alcohol abuse.

The Effect of Blood Alcohol Level and Preinjury Chronic Alcohol Use on Outcome From Severe Traumatic Brain Injury in Hispanics, Anglo-Caucasians, and African-Americans

“…These results are contrary to what have been reported in some previous investigations, 6,31 but similar to the modest paradoxical relationship reported by Vickery et al 15 and lack of relationship reported by De Guise et al 17 However, through exploratory analysis of potential interaction between our three main independent variables of interest, it was found that ethnicity and PI-ETOH interacted in predicting 6 month post-injury DRS scores. More specifically, Anglo-Caucasians and African Americans showed the predicted pattern in which PI-ETOH was associated with higher DRS scores (i.e., worse outcome).…”

“…Some studies have shown that acute alcohol intoxication is related to increased length of hospitalization, 3,5,13 longer coma duration, 13 and lower global cognitive and functional outcome, 5,14,15 while other investigations have not shown these effects. 5-7,15,16 Likewise, studies investigating the relationship between PI-ETOH and early outcome have found that PI-ETOH was associated with lower initial Glasgow Coma Scale (GCS) scores, 15 increased length of hospitalization, 17 longer post traumatic amnesia (PTA), 17 and poorer acute global outcome, 6 although there is again conflicting evidence. 15,16,18 …”

“…1,3 Investigators have been unable to detect an association between BAL and global outcome, as measured by the Glasgow Outcome Scale (GOS), at 3, 6, and 12 months post-injury. 6,17,19-21 Moreover, one study reported the paradoxical finding that acute alcohol intoxication was related to better global outcome, as measured by the Functional Independence Measure (FIM). 22 A notable exception to this body of literature consisting of largely null and paradoxical results, is a recent study by Vickery and colleagues in which increased BAL was associated with higher Disability Rating Scale (DRS) scores (i.e.…”

“…While there is some evidence that a history of PI-ETOH is related to poorer global outcomes, 6,23 others report no relationship. 17 Furthermore, Vickery et al reported the paradoxical finding that pre-injury “binge drinking” was actually associated with better global outcome on the DRS. 15 The authors explained the latter finding by positing that individuals who are more productive pre-injury might have fewer occasions to drink but tend to consume in higher quantities when they do drink.…”

Determinants of mortality in patients with traumatic brain injury

“…[17] Limitations of the Study Hypoxia, hyperthermia and alcohol consumption were significant risk factors in other studies. [18][19][20][21][22][23] However, we did not point to these factors in our study. Although it has been shown that bradypnea had an unfavorable prognosis in TBI, considering arterial blood gases could add valuable information in analyzing respiratory function.…”