Incidence of moderate-to-severe traumatic brain injuries after reduction in alcohol prices

Puljula, Jussi; Mäkinen, Elina; Cygnel, H.; Kortelainen, Marja-Leena; Hillbom, Matti

doi:10.1111/j.1600-0404.2012.01697.x

Cited by 22 publications

(18 citation statements)

References 24 publications

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“…The age span and the TBI severity may limit generalization of the results. However, the demographic and injury characteristics were similar to other studies on moderate-to-severe TBI (10,36). As the level of consciousness in the early phase of TBI might be obscured because of substance influence, medical sedation, seizures, shock, etc., we cannot rule out a potential bias introduced by using early GCS score as the inclusion criteria (1).…”

Section: Pcs Mcssupporting

confidence: 69%

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury

et al. 2013

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Aims -To describe health-related quality of life (HRQL) 2 years after moderate-to-severe traumatic brain injury (TBI) and to assess predictors of HRQL. Materials and methods -A prospective cohort study of 91 patients, aged 16-55 years, admitted with moderate-tosevere TBI to a trauma referral centre between 2005 and 2007, with follow-up at 1 and 2 years. Mean age was 31.1 (SD = 11.3) years, and 77% were men. Injury severity was evaluated by the Glasgow Coma Scale (GCS), head CT scan (using a modified Marshall Classification), Injury Severity Score (ISS) and post-traumatic amnesia (PTA). The Functional Independence Measure (FIM), Community Integration Questionnaire (CIQ), Beck Depression Inventory (BDI) and Medical Outcomes 36-item Short Form Health Survey (SF-36) were administered at follow-up visits. The main outcome measures were the Physical Component Summary (PCS) and Mental Component Summary (MCS) of the SF-36. Results -HRQL appears to be relatively stable between 1 and 2 years after injury. In the multivariate linear regression, younger age (b = À0.20, P = 0.032), more severe TBI (b = 0.28, P = 0.016), more severe overall trauma (b = 0.22, P = 0.026), higher levels of community integration (b = 0.36, P = 0.019) and higher positive change in PCS scores from 1 to 2 years (b = 0.41, P < 0.001) predicted better self-reported physical health 2 years post-TBI. Lower scores for depression (b = À0.70, P < 0.001) and a higher positive change in MCS scores (b = 0.62, P < 0.001) predicted better self-reported mental health. Conclusions -Future interventions should focus on aspects related to HRQL that are more easily modified, such as physical functioning, home and social integration, productivity, and mental and emotional status.

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Section: Pcs Mcssupporting

confidence: 69%

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury

et al. 2013

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“…Nevertheless, it is known that alcohol related falls are often associated with severe craniofacial trauma and alcohol intoxication is also a well known risk factor for TBI . Moreover, alcohol and older age predicts fatal outcome . The mortality (defined as GOS 1) in our study was 18.2% but Brazinova et al report a wide range of mortality rates in their systematic review on TBI in Europe; from 9/100.000/year to 28/100.000/year in national level studies like ours, but those numbers include all TBI, not only TBI admitted to the ICU .…”

Section: Discussioncontrasting

confidence: 56%

A population‐based study on epidemiology of intensive care unit treated traumatic brain injury in Iceland

Jónsdóttir

Lund

Snorradottir

et al. 2017

Acta Anaesthesiol Scand

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Incidence decreased with a shift in injury mechanism from road traffic accidents to falls and an increased rate of traumatic brain injury in older patients following a fall from standing or low heights. Mortality was higher in older patients falling from low heights than in younger patients suffering multiple injuries in road traffic accidents. Age, injury severity score, acute physiology and chronic health evaluation II score and Marshall score are good prognostic factors for outcome. Traumatic brain injury continues to be a considerable problem and the increase in severe traumatic brain injury in the middle age and older age groups after a seemingly innocent accident needs a special attention.

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“…). A borderline significant link was found when we omitted Gururaj's () study (OR = 0.90, 95% CI = 0.82 to 0.99), Puljula and colleagues () study (OR = 0.90, 95% CI = 0.82 to 0.99), Pandit and colleagues () (OR = 0.90, 95% CI = 0.82 to 0.99), or Lin and colleagues () study (OR = 0.89, 95% CI = 0.81 to 0.97). The other results of sensitivity analysis for different BACs were not altered.…”

Section: Resultsmentioning

confidence: 83%

“…Our initial result found that alcohol exposure at the time of injury did not decrease the mortality rate, which is not consistent with the 2 previous meta‐analyses. Despite the potential neuroprotective mechanisms, numerous recently published studies also confirmed that alcohol exposure did not decrease or increase mortality rate (Lin et al., ; Pandit et al., ; Puljula et al., ). Nevertheless, the notable heterogeneity and the results of sensitivity analysis of our current results leave the conclusion ambiguous.…”

Section: Discussionmentioning

confidence: 94%

Acute Alcohol Exposure and Risk of Mortality of Patients with Traumatic Brain Injury: A Systematic Review and Meta-Analysis

Ding

Wang

Shen

et al. 2017

Alcohol Clin Exp Res

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After traumatic brain injury (TBI), patients usually live with significant disability and socioeconomic burdens. Acute exposure to alcohol is considered a major risk factor for TBI. Numerous studies have examined whether alcohol exposure is related to the risk of mortality in patients with TBI, yet the results remain inconsistent. We performed a meta-analysis to assess whether acute alcohol exposure affects the mortality rate of TBI patients. We searched PubMed, EMBASE, and the Cochrane Library up to November 2015 for relevant studies. We screened studies based on their inclusion criteria and selected the studies that reported mortality rate, which included 18 observational studies. We used R to analyze the included data. An initial result showed that the presence of a positive blood alcohol concentration (BAC) had no significant relation with mortality rate (OR = 0.92, 95% CI = 0.83 to 1.01), but there was notable heterogeneity along with variable results according to sensitivity analysis. For the BAC-positive population, low BAC (1 to 100 mg/dl) carried a higher risk of mortality than moderate BAC (100 to 230 mg/dl) (OR = 1.40, 95% CI = 1.09 to 1.81), moderate and high BAC as a single category (>100 mg/dl) (OR = 1.57, 95% CI = 1.28 to 1.94), or high BAC (>230 mg/dl) (OR = 1.76, 95% CI = 1.34 to 2.30). However, moderate BAC did not increase the mortality risk when compared with high BAC (OR = 1.20, 95% CI = 0.89 to 1.63). Whether positive BAC at the time of admission after TBI reduces mortality rate compared with the rate under negative BAC remains unknown. In addition, low BAC (1 to 100 mg/dl) poses a risk of mortality compared with higher BAC. Further studies assessing the effect of alcohol between the BAC-positive group and the BAC-negative group are still needed.

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Incidence of moderate-to-severe traumatic brain injuries after reduction in alcohol prices

Abstract: The reduction in alcohol prices and the concomitant increase in alcohol consumption did not increase the incidence of alcohol-related moderate-to-severe TBI.

Cited by 22 publications

References 24 publications

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury

A population‐based study on epidemiology of intensive care unit treated traumatic brain injury in Iceland

Acute Alcohol Exposure and Risk of Mortality of Patients with Traumatic Brain Injury: A Systematic Review and Meta-Analysis

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