Effect of alcohol in traumatic brain injury: Is it really protective?

Viraj Pandit, Nikita Patel, Peter M Rhee, Narong Kulvatunyou, Hassan Aziz, Donald J. Green, Terence S Okeeffe, Bardiya Zangbar, Andrew - Tang, Lynn Gries, Randall S Friese, Bellal A Joseph

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI. Methods Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4) and blood ETOH levels recorded on admission. Primary outcome measure was mortality. Multivariate logistic regression analysis was performed to assess factors predicting mortality and in-hospital complications. Results A total of 23,983 patients with severe TBI were evaluated of which 22.8% (n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients were more likely to have in-hospital complications (P = 0.001) and have a higher mortality rate (P = 0.01). ETOH intoxication was an independent predictor for mortality (odds ratio: 1.2, 95% confidence interval: 1.1-2.1, P = 0.01) and development of in-hospital complications (odds ratio: 1.3, 95% confidence interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI. Conclusions ETOH intoxication is an independent predictor for mortality in patients with severe TBI patients and is associated with higher complication rates. Our results from the National Trauma Data Standards differ from those previously reported. The proposed neuroprotective role of ETOH needs further clarification.

Original languageEnglish (US)
Pages (from-to)634-639
Number of pages6
JournalJournal of Surgical Research
Volume190
Issue number2
DOIs
StatePublished - 2014

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Alcohols
Mortality
Odds Ratio
Confidence Intervals
Traumatic Brain Injury
Wounds and Injuries
Hospital Mortality
Craniocerebral Trauma
Logistic Models
Regression Analysis
Outcome Assessment (Health Care)
Databases

Keywords

  • Alcohol intoxication
  • Complications
  • Mortality
  • National trauma data bank
  • Severe traumatic brain injury

ASJC Scopus subject areas

  • Surgery

Cite this

Effect of alcohol in traumatic brain injury : Is it really protective? / Pandit, Viraj; Patel, Nikita; Rhee, Peter M; Kulvatunyou, Narong; Aziz, Hassan; Green, Donald J.; Okeeffe, Terence S; Zangbar, Bardiya; Tang, Andrew -; Gries, Lynn; Friese, Randall S; Joseph, Bellal A.

In: Journal of Surgical Research, Vol. 190, No. 2, 2014, p. 634-639.

Research output: Contribution to journalArticle

Pandit, Viraj ; Patel, Nikita ; Rhee, Peter M ; Kulvatunyou, Narong ; Aziz, Hassan ; Green, Donald J. ; Okeeffe, Terence S ; Zangbar, Bardiya ; Tang, Andrew - ; Gries, Lynn ; Friese, Randall S ; Joseph, Bellal A. / Effect of alcohol in traumatic brain injury : Is it really protective?. In: Journal of Surgical Research. 2014 ; Vol. 190, No. 2. pp. 634-639.
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abstract = "Background Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI. Methods Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4) and blood ETOH levels recorded on admission. Primary outcome measure was mortality. Multivariate logistic regression analysis was performed to assess factors predicting mortality and in-hospital complications. Results A total of 23,983 patients with severe TBI were evaluated of which 22.8{\%} (n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients were more likely to have in-hospital complications (P = 0.001) and have a higher mortality rate (P = 0.01). ETOH intoxication was an independent predictor for mortality (odds ratio: 1.2, 95{\%} confidence interval: 1.1-2.1, P = 0.01) and development of in-hospital complications (odds ratio: 1.3, 95{\%} confidence interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI. Conclusions ETOH intoxication is an independent predictor for mortality in patients with severe TBI patients and is associated with higher complication rates. Our results from the National Trauma Data Standards differ from those previously reported. The proposed neuroprotective role of ETOH needs further clarification.",
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N2 - Background Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI. Methods Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4) and blood ETOH levels recorded on admission. Primary outcome measure was mortality. Multivariate logistic regression analysis was performed to assess factors predicting mortality and in-hospital complications. Results A total of 23,983 patients with severe TBI were evaluated of which 22.8% (n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients were more likely to have in-hospital complications (P = 0.001) and have a higher mortality rate (P = 0.01). ETOH intoxication was an independent predictor for mortality (odds ratio: 1.2, 95% confidence interval: 1.1-2.1, P = 0.01) and development of in-hospital complications (odds ratio: 1.3, 95% confidence interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI. Conclusions ETOH intoxication is an independent predictor for mortality in patients with severe TBI patients and is associated with higher complication rates. Our results from the National Trauma Data Standards differ from those previously reported. The proposed neuroprotective role of ETOH needs further clarification.

AB - Background Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI. Methods Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4) and blood ETOH levels recorded on admission. Primary outcome measure was mortality. Multivariate logistic regression analysis was performed to assess factors predicting mortality and in-hospital complications. Results A total of 23,983 patients with severe TBI were evaluated of which 22.8% (n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients were more likely to have in-hospital complications (P = 0.001) and have a higher mortality rate (P = 0.01). ETOH intoxication was an independent predictor for mortality (odds ratio: 1.2, 95% confidence interval: 1.1-2.1, P = 0.01) and development of in-hospital complications (odds ratio: 1.3, 95% confidence interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI. Conclusions ETOH intoxication is an independent predictor for mortality in patients with severe TBI patients and is associated with higher complication rates. Our results from the National Trauma Data Standards differ from those previously reported. The proposed neuroprotective role of ETOH needs further clarification.

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