title: Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries.
abstract: BACKGROUND
  In 2000 the Scandinavian Neurotrauma Committee published guidelines for safe and cost-effective management of minimal, mild and moderate head injured patients.The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate whether the physicians' compliance to the guidelines is affected when patients are influenced by alcohol.
  
  
  METHODS
  This study included adult patients (≥15 years) referred to a Norwegian University Hospital with minimal, mild and moderate head injuries classified according to the Head Injury Severity Scale (HISS). Information on alcohol consumption was recorded, and in most of these patients blood alcohol concentration (BAC) was measured. Compliance with the above mentioned guidelines was registered.
  
  
  RESULTS
  The study includes 860 patients. 35.8% of the patients had consumed alcohol, and 92.1% of these patients had a BAC ≥ 1.00‰. Young age, male gender, trauma occurring during the weekends, mild and moderate head injuries were independent factors significantly associated with being under the influence of alcohol. Guideline compliance was 60.5%, and over-triage was the main violation. The guideline compliance showed no significant correlation to alcohol consumption or to BAC-level.
  
  
  CONCLUSIONS
  This study confirms that alcohol consumption is common among patients with head injuries. The physicians' guideline compliance was not affected by the patients' alcohol consumption, and alcohol influence could therefore not explain the low guideline compliance.
authors.affiliation: Department of Neurosurgery, Oslo University Hospital - Ullevål, Norway. marianne.efskind@gmail.com
authors.forename: Marianne Efskind
authors.initials: ME
authors.lastname: Harr
authors.forename: Ben
authors.initials: B
authors.lastname: Heskestad
authors.forename: Tor
authors.initials: T
authors.lastname: Ingebrigtsen
authors.forename: Bertil
authors.initials: B
authors.lastname: Romner
authors.forename: Pål
authors.initials: P
authors.lastname: Rønning
authors.forename: Eirik
authors.initials: E
authors.lastname: Helseth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D006259:Craniocerebral Trauma / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D000431:Ethanol / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D014218:Triage; D055815:Young Adult
chemical_list: D000431:Ethanol