title: Recurrent traumatic brain injury is predicted by the index injury occurring under the influence of alcohol.
abstract: BACKGROUND
  Little is known of the role of alcohol intoxication as a risk factor for recurrent traumatic brain injuries (TBI). This study was a population-based longitudinal study to investigate this problem.
  
  
  METHODS
  The record linkage technique was used and data gathered from the Finnish Hospital Discharge Register, hospital records and by a questionnaire of family characteristics regarding the 12 058 subjects forming the Northern Finland Birth Cohort of 1966. Excluded were TBI subjects injured before the age of 12 years.
  
  
  RESULTS
  Of the 236 patients who had survived their first (mainly mild) TBI, 21 had had a recurrent TBI and three of them two recurrent TBIs during the follow-up period (from 1978-2000). An alcohol-related first injury (RR 4.41, 95% CI 1.53-12.70) and urban place of birth (RR 4.39, 95% CI 1.68-11.48) were significant independent predictors of recurrent TBI. A significant positive correlation between the first and recurrent TBIs with respect to alcohol involvement (rs = 0.61, p = 0.003) was observed.
  
  
  CONCLUSIONS
  A first TBI related to alcohol drinking is predictive of recurrent TBI, which will often similarly be alcohol-related. The risk of recurrent injury seems to extend over several years after the first TBI. To prevent recurrence, efforts should be made to identify those with an alcohol-related first TBI. A brief intervention focused on drinking habits is needed as an immediate preventive measure.
authors.affiliation: Department of Neurology, University of Oulu, Finland. satu.winqvist@oulu.fi
authors.forename: Satu
authors.initials: S
authors.lastname: Winqvist
authors.forename: Heikki
authors.initials: H
authors.lastname: Luukinen
authors.forename: Jari
authors.initials: J
authors.lastname: Jokelainen
authors.forename: Maria
authors.initials: M
authors.lastname: Lehtilahti
authors.forename: Simo
authors.initials: S
authors.lastname: Näyhä
authors.forename: Matti
authors.initials: M
authors.lastname: Hillbom
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology / Q000517:prevention & control; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008498:Medical Record Linkage; D011237:Predictive Value of Tests; D018570:Risk Assessment; D055502:Secondary Prevention; D015599:Trauma Severity Indices; D055815:Young Adult