Alcohol and risk of mortality in patients with traumatic brain injury.

BACKGROUND

Laboratory and clinical studies demonstrate inconsistent findings on the effect of alcohol on traumatic brain injury (TBI) outcome. The purpose of this study is to use a comprehensive trauma database to determine whether blood alcohol concentration (BAC) is associated with mortality in patients with TBI.

DESIGN

Cohort study.

SETTING

Eighteen trauma centers and 51 nontrauma centers in the United States.

PATIENTS: A total of 1,529 patients aged 18 years to 84 years of age admitted to hospital with TBI between July 2001 and November 2002.

EXPOSURE: BAC assessed in the index hospital emergency department.

OUTCOME: Mortality in-hospital, 90 and 365 days after injury.

RESULTS

After adjusting for confounding variables, there was no significant difference for in-hospital, 90-day, and 365-day mortality by BAC.

CONCLUSIONS

When fully adjusted for injury severity, alcohol intoxication is not associated with significantly lower mortality after TBI. The trend toward lower mortality at higher BACs prompts questions about the complex interaction of alcohol and TBI, and warrants further investigation of the possible protective effect of alcohol.