Citation

Raj R, Skrifvars MB, Kivisaari R, Hernesniemi J, Lappalainen J, Siironen J. J. Neurotrauma 2014; 32(2): 95-100.

Affiliation

Helsinki University Hospital, Department of Neurosurgery , Topeliuksenkatu 5 , Helsinki, Finland , 00029 HUS ; rahul.br.raj@icloud.com.

Copyright

(Copyright © 2014, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3488

PMID

25010885

Abstract

The effect of blood alcohol concentrations (BAC) on outcome after traumatic brain injury (TBI) is controversial. We sought to assess the independent effect of positive BAC on long-term outcome in patients with TBI treated in the intensive care unit (ICU). We performed a retrospective analysis of 405 patients with TBI admitted to the ICU of a large urban level-1 trauma center between Jan 2009 and Dec 2012. Outcome was six-month mortality and unfavourable neurological outcome (defined as Glasgow Outcome Scale 1 [death], 2, [vegetative state], 3 [severe disability]). Patients were categorized by admission BAC to: no BAC (0.0‰, n=99), low BAC (<2.3‰, n=140) and high BAC (≥2.3 ‰, n=166). Logistic regression analysis, adjusting for baseline risk and severity of illness, was used to assess the independent effect of BAC on outcome, using the no BAC group as reference. Overall six-month mortality was 25% and unfavourable outcome 46%. Multivariate analysis showed low BAC to independently reduce risk of six-month mortality compared to no BAC (low BAC adjusted odds ratio [AOR] 0.41, 95% confidence interval [CI] 0.19-0.88, p=0.021 and high BAC AOR 0.58, 95% CI 0.29-1.15, p=0.120). Furthermore, a trend towards reduced risk of six-month unfavourable neurological outcome for patients with low BAC and high BAC, as compared to no BAC was noted, although not reaching statistical significance (low BAC AOR 0.65, 95% CI 0.34-1.22, p=0.178 and high BAC AOR 0.59, 95% CI 0.32-1.09, p=0.089). In conclusion, low admission BAC (<2.3‰) was found to independently reduce risk of six-month mortality for patients with TBI and a trend towards improved long-term neurological outcome was found for the BAC positive patients. The role of alcohol as a neuroprotective agent warrants further studies.

Language: en