@article{ref1,
title="Alcohol is not protective against mortality following traumatic brain injury",
journal="American journal of epidemiology",
year="2018",
author="Albrecht, Jennifer S. and Afshar, Majid and Stein, Deborah M. and Smith, Gordon C. S.",
volume="187",
number="2",
pages="233-241",
abstract="Alcohol exposure results in reduced mortality following traumatic brain injury (TBI) in animal models, yet clinical studies reported conflicting results and clinical trials based on proposed mechanisms have been disappointing. <br><br>METHODological issues common to many of the clinical studies may have contributed to spurious results. Our objective was to evaluate the association between blood alcohol concentration (BAC) and in-hospital mortality following TBI, overcoming methodological problems of prior studies. We conducted a retrospective cohort study on individuals treated for isolated TBI at the R Adams Cowley Shock Trauma Center between 1997-2012 (n = 1,084). We excluded individuals with injury to other body regions and examined multiple cut-points of BAC. Our primary outcome was in-hospital mortality. In adjusted logistic regression models, the upper level of each blood alcohol categorization from 0.10 g/dL (odds ratio 0.63; 95% confidence interval 0.40,0.97) through 0.30 g/dL (odds ratio 0.25; 95% confidence interval 0.08,0.84) was associated with reduced risk of mortality following TBI compared to BAC-. In sensitivity analyses among individuals without penetrating (95% firearm) brain injuries (n = 899), the protective association was eliminated. This study provides evidence that the observed protective association between blood alcohol and in-hospital mortality following TBI resulted from bias introduced by inclusion of penetrating injuries.<br><br>© The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.<p /> <p>Language: en</p>",
language="en",
issn="0002-9262",
doi="10.1093/aje/kwx254",
url="http://dx.doi.org/10.1093/aje/kwx254"
}