title: Ethanol exposure and isolated traumatic brain injury.
abstract: This study aims to investigate an association between ethanol exposure and in-hospital mortality among patients with isolated traumatic brain injury (iTBI). Ethanol exposure is associated with a substantially increased risk of sustaining an iTBI. However, once an iTBI has been sustained, it is unclear whether ethanol exposure is neuroprotective or harmful. We conducted a retrospective review of patients who presented between 2006 and 2012 and were entered into the Alfred Hospital trauma registry. The patients who presented with iTBI, as defined by a head abbreviated injury scale (AIS) score ⩾3 and all other body regions with AIS<3, and who had ethanol levels recorded on admission, were eligible for inclusion. The association between ethanol exposure as a continuous variable, and in-hospital mortality, was explored using multivariable logistic regression analysis. There were 1688 patients with iTBI who met the inclusion criteria, 577 (34.2%) of whom tested positive for ethanol. Ethanol exposure was not significantly associated with a change in the in-hospital mortality rate (adjusted odds ratio 1.01; 95% confidence interval 1.00-1.02; p=0.19). A substantial proportion of patients with iTBI were exposed to ethanol, but ethanol exposure was not independently associated with a change in mortality rate following iTBI. Any neuroprotection or harm from ethanol exposure was not conclusive, requiring further prospective trials.
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, VIC, Australia. Electronic address: jhbre2@student.monash.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Brennan
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, VIC, Australia; Intensive Care Unit, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bernard
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, VIC, Australia; Emergency Medicine, Hamad Medical Corporation, Doha, Qatar; National Trauma Research Institute, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia; Trauma Service, The Alfred Hospital, Melbourne, VIC, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Olaussen
authors.affiliation: Trauma Service, The Alfred Hospital, Melbourne, VIC, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Fitzgerald
authors.affiliation: National Trauma Research Institute, The Alfred Hospital, Melbourne, VIC, Australia; Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC, Australia; Department of Surgery, Monash University, Melbourne, VIC, Australia; Department of Surgery, F. Edward Hébert School of Medicine, Uniformed Services University of The Health Sciences, Bethesda, MD, USA.
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Rosenfeld
authors.affiliation: Emergency and Trauma Centre, The Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia; Department of Epidemiology and Preventive Medicine, Monash University, The Alfred Centre, Melbourne, VIC, Australia; National Trauma Research Institute, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Biswadev
authors.initials: B
authors.lastname: Mitra
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D001930:Brain Injuries / Q000150:complications / Q000401:mortality*; D000431:Ethanol; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies
chemical_list: D000431:Ethanol
keywords: Blood alcohol; Brain injury; Ethanol; Ethanol exposure; Isolated traumatic brain injury