title: Effect of alcohol in traumatic brain injury: is it really protective?
abstract: BACKGROUND
  Studies have proposed a neuroprotective role for alcohol (ETOH) in traumatic brain injury (TBI). We hypothesized that ETOH intoxication is associated with mortality in patients with severe TBI.
  
  
  METHODS
  Version 7.2 of the National Trauma Data Bank (2007-2010) was queried for all patients with isolated blunt severe TBI (Head Abbreviated Injury Score ≥4) and blood ETOH levels recorded on admission. Primary outcome measure was mortality. Multivariate logistic regression analysis was performed to assess factors predicting mortality and in-hospital complications.
  
  
  RESULTS
  A total of 23,983 patients with severe TBI were evaluated of which 22.8% (n = 5461) patients tested positive for ETOH intoxication. ETOH-positive patients were more likely to have in-hospital complications (P = 0.001) and have a higher mortality rate (P = 0.01). ETOH intoxication was an independent predictor for mortality (odds ratio: 1.2, 95% confidence interval: 1.1-2.1, P = 0.01) and development of in-hospital complications (odds ratio: 1.3, 95% confidence interval: 1.1-2.8, P = 0.009) in patients with isolated severe TBI.
  
  
  CONCLUSIONS
  ETOH intoxication is an independent predictor for mortality in patients with severe TBI patients and is associated with higher complication rates. Our results from the National Trauma Data Standards differ from those previously reported. The proposed neuroprotective role of ETOH needs further clarification.
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Viraj
authors.initials: V
authors.lastname: Pandit
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Nikita
authors.initials: N
authors.lastname: Patel
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Narong
authors.initials: N
authors.lastname: Kulvatunyou
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Hassan
authors.initials: H
authors.lastname: Aziz
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Green
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Bardiya
authors.initials: B
authors.lastname: Zangbar
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Andrew
authors.initials: A
authors.lastname: Tang
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Lynn
authors.initials: L
authors.lastname: Gries
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors.forename: Randall S
authors.initials: RS
authors.lastname: Friese
authors.affiliation: Division of Trauma, Critical Care, Emergency Surgery and Burns, Department of Surgery, University of Arizona, Tucson, Arizona. Electronic address: bjoseph@surgery.arizona.edu.
authors.forename: Bellal
authors.initials: B
authors.lastname: Joseph
mesh_terms: D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000150:complications*; D001930:Brain Injuries / Q000150:complications* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol intoxication; Complications; Mortality; National trauma data bank; Severe traumatic brain injury