Alcohol use is a major risk factor for trauma and about one-third to one-half of patients hospitalized with trauma are intoxicated at the time of injury. Studies have been inconclusive on the effect of alcohol on patients after a traumatic brain injury but some have suggested that alcohol may be neuroprotective, keeping the injury from worsening.
Homer C. N. Tien, M.D., F.R.C.S.C., Sunnybrook Health Sciences Centre, University of Toronto, and colleagues studied 1,158 consecutive patients with severe brain injury caused by blunt trauma between 1988 and 2003. Blood alcohol concentration (BAC) was determined when the patients were admitted. Additional data was determined on demographics, type of injury, severity of the injury, length of hospital stay and whether the patient died or left the hospital, was gathered from the hospital’s trauma registry. For a control group, researchers assessed a group of 528 patients with severe torso injuries, but no or mild head injuries.
Of the 1,158 traumatic brain injury patients, those with a low to moderate BAC (0 to 230 milligrams per deciliter) were less likely to die than those with no BAC (27.9 percent died vs. 36.3 percent). After adjusting for other factors, including injury severity, blood transfusions and whether the trauma occurred in a motor vehicle crash, BAC continued to be associated with the risk of death. Patients with a low to moderate BAC had 24 percent lower odds of dying in the hospital than those with no BAC. Patients with a high BAC had 73 percent higher odds of dying than those with no BAC. BAC was not associated with death risk for patients with torso injuries.
The researchers concluded that low to moderate doses of alcohol may protect the brain by stopping mechanisms that contribute to secondary brain injury if they arrive alive to the hospital. However, they indicated that half of all individuals who die from trauma do so before they arrive at the hospital.
Implications of the study include a possible role for an alcohol-based resuscitation in improving outcomes in adequately resuscitated patients with severe head injury.
About the Author
Jeanne Bohm, Ph.D. is a cancer biologist by training, a medical writer and an experienced science educator.
The author has no financial relationship to any of the companies listed in the article.
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