Abstract
We collected data on all residents of San Diego County, California who were hospitalized for or died from a brain injury in 1981. The objectives were to assess the frequency of blood alcohol concentration (BAC) testing and the associations of BAC prevalence with the external cause of the brain injury and case outcome. We found that high BAC levels were most frequent among brain-injured subjects between the ages of 25 and 44 and among those subjects involved in motor vehicle crashes and assaults. Contrary to expectations, injury severity and hospital mortality were inversely related to BAC level, controlling for other predictors. We believe that these inverse associations might be due to differential rates of BAC testing by severity. Among brain-injured survivors with more severe injuries, however, we found that BAC level was positively associated with the prevalence of physician-diagnosed neurological impairment at discharge and with the length of hospitalization.
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- Albin M. S., Bunegin L. An experimental study of craniocerebral trauma during ethanol intoxication. Crit Care Med. 1986 Oct;14(10):841–846. doi: 10.1097/00003246-198610000-00001. [DOI] [PubMed] [Google Scholar]
- Baker S. P., O'Neill B., Haddon W., Jr, Long W. B. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974 Mar;14(3):187–196. [PubMed] [Google Scholar]
- Baker S. P., O'Neill B. The injury severity score: an update. J Trauma. 1976 Nov;16(11):882–885. doi: 10.1097/00005373-197611000-00006. [DOI] [PubMed] [Google Scholar]
- Blomqvist S., Thörne J., Elmér O., Jönsson B. A., Strand S. E., Lindahl S. G. Early post-traumatic changes in hemodynamics and pulmonary ventilation in alcohol-pretreated pigs. J Trauma. 1987 Jan;27(1):40–44. doi: 10.1097/00005373-198701000-00007. [DOI] [PubMed] [Google Scholar]
- Brismar B., Engström A., Rydberg U. Head injury and intoxication: a diagnostic and therapeutic dilemma. Acta Chir Scand. 1983;149(1):11–14. [PubMed] [Google Scholar]
- DeCrescito V., Demopoulos H. B., Flamm E. S., Ransohoff J., 2nd Ethanol potentiation of traumatic cerebral edema. Surg Forum. 1974;25(0):438–440. [PubMed] [Google Scholar]
- Desiderio M. A. Effects of acute, oral ethanol on cardiovascular performance before and after experimental blunt cardiac trauma. J Trauma. 1987 Mar;27(3):267–277. doi: 10.1097/00005373-198703000-00007. [DOI] [PubMed] [Google Scholar]
- Edna T. H. Alcohol influence and head injury. Acta Chir Scand. 1982;148(3):209–212. [PubMed] [Google Scholar]
- Flamm E. S., Demopoulos H. B., Seligman M. L., Tomasula J. J., De Crescito V., Ransohoff J. Ethanol potentiation of central nervous system trauma. J Neurosurg. 1977 Mar;46(3):328–335. doi: 10.3171/jns.1977.46.3.0328. [DOI] [PubMed] [Google Scholar]
- GETTLER D. T., ALLBRITTEN F. F., Jr EFFECT OF ALCOHOL INTOXICATION ON THE RESPIRATORY EXCHANGE AND MORTALITY RATE ASSOCIATED WITH ACUTE HEMORRHAGE IN ANESTHETIZED DOGS. Ann Surg. 1963 Aug;158:151–158. doi: 10.1097/00000658-196308000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Galbraith S., Murray W. R., Patel A. R., Knill-Jones R. The relationship between alcohol and head injury and its effect on the conscious level. Br J Surg. 1976 Feb;63(2):128–130. [PubMed] [Google Scholar]
- Hadfield J. M., Stoner H. B. Interactions between ethanol and the responses to injury. J Trauma. 1983 Jun;23(6):518–522. doi: 10.1097/00005373-198306000-00013. [DOI] [PubMed] [Google Scholar]
- Hervè C., Gaillard M., Roujas F., Huguenard P. Alcoholism in polytrauma. J Trauma. 1986 Dec;26(12):1123–1126. doi: 10.1097/00005373-198612000-00013. [DOI] [PubMed] [Google Scholar]
- Holt S., Stewart I. C., Dixon J. M., Elton R. A., Taylor T. V., Little K. Alcohol and the emergency service patient. Br Med J. 1980 Sep 6;281(6241):638–640. doi: 10.1136/bmj.281.6241.638. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Huth J. F., Maier R. V., Simonowitz D. A., Herman C. M. Effect of acute ethanolism on the hospital course and outcome of injured automobile drivers. J Trauma. 1983 Jun;23(6):494–498. doi: 10.1097/00005373-198306000-00009. [DOI] [PubMed] [Google Scholar]
- Jagger J., Fife D., Vernberg K., Jane J. A. Effect of alcohol intoxication on the diagnosis and apparent severity of brain injury. Neurosurgery. 1984 Sep;15(3):303–306. doi: 10.1227/00006123-198409000-00002. [DOI] [PubMed] [Google Scholar]
- Kraus J. F., Black M. A., Hessol N., Ley P., Rokaw W., Sullivan C., Bowers S., Knowlton S., Marshall L. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol. 1984 Feb;119(2):186–201. doi: 10.1093/oxfordjournals.aje.a113737. [DOI] [PubMed] [Google Scholar]
- Kraus J. F., Fife D., Conroy C. Incidence, severity, and outcomes of brain injuries involving bicycles. Am J Public Health. 1987 Jan;77(1):76–78. doi: 10.2105/ajph.77.1.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kraus J. F., Fife D., Ramstein K., Conroy C., Cox P. The relationship of family income to the incidence, external causes, and outcomes of serious brain injury, San Diego County, California. Am J Public Health. 1986 Nov;76(11):1345–1347. doi: 10.2105/ajph.76.11.1345. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Luna G. K., Maier R. V., Sowder L., Copass M. K., Oreskovich M. R. The influence of ethanol intoxication on outcome of injured motorcyclists. J Trauma. 1984 Aug;24(8):695–700. doi: 10.1097/00005373-198408000-00001. [DOI] [PubMed] [Google Scholar]
- MOSS L. K., CHENAULT O. W., Jr, GASTON E. A., Jr The effects of alcohol ingestion on experimental hemorrhagic shock. Surg Forum. 1960;10:390–392. [PubMed] [Google Scholar]
- Seligman M. L., Flamm E. S., Goldstein B. D., Poser R. G., Demopoulos H. B., Ransohoff J. Spectrofluorescent detection of malonaldehyde as a measure of lipid free radical damage in response to ethanol potentiation of spinal cord trauma. Lipids. 1977 Nov;12(11):945–950. doi: 10.1007/BF02533316. [DOI] [PubMed] [Google Scholar]
- Smith G. S., Kraus J. F. Alcohol and residential, recreational, and occupational injuries: a review of the epidemiologic evidence. Annu Rev Public Health. 1988;9:99–121. doi: 10.1146/annurev.pu.09.050188.000531. [DOI] [PubMed] [Google Scholar]
- Soderstrom C. A., DuPriest R. W., Jr, Benner C., Maekawa K., Cowley R. A. Alcohol and roadway trauma: problems of diagnosis and management. Am Surg. 1979 Feb;45(2):129–136. [PubMed] [Google Scholar]
- Waller P. F., Stewart J. R., Hansen A. R., Stutts J. C., Popkin C. L., Rodgman E. A. The potentiating effects of alcohol on driver injury. JAMA. 1986 Sep 19;256(11):1461–1466. [PubMed] [Google Scholar]
- Ward R. E., Flynn T. C., Miller P. W., Blaisdell W. F. Effects of ethanol ingestion on the severity and outcome of trauma. Am J Surg. 1982 Jul;144(1):153–157. doi: 10.1016/0002-9610(82)90617-1. [DOI] [PubMed] [Google Scholar]