title: Trends in alcohol use during moderate and severe traumatic brain injury: 18 years of neurotrauma in Pennsylvania.
abstract: Alcohol is a known risk factor for TBI, yet little is known about how rates of alcohol use at time of injury differ across demographics and the stability of alcohol-related injury over time. Further, findings examining the relationship between alcohol and outcome are mixed. This study aimed to examine changes in alcohol-positive moderate-to-severe traumatic brain injury (+aTBI) over two decades with focus on demographic factors, changes in +aTBI frequency over time, mortality and acute outcome.
  
  
  
  This retrospective study examined data collected from 1992-2009 by the Pennsylvania Trauma Outcome Study (PTOS).
  
  
  
  Results reveal that the proportion of +aTBI has been generally stable across years. However, there is an interaction of +aTBI incidence with mechanism of injury and age, with a downward trend in +aTBI within MVA and fall and individuals 18-30 and 71+ years. Further, consistent with several findings in the literature, alcohol was associated with higher rates of survival and better FSD scores during acute recovery.
  
  
  
  This study discusses findings in the context of a greater literature on TBI-related alcohol and outcome. The injury-alcohol profiles highlighted could be used to inform future allocation of resources toward prevention of, intervention for and care of individuals who sustain TBI.
authors.affiliation: a Department of Psychology , The Pennsylvania State University, University Park , PA , USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Bernier
authors.affiliation: a Department of Psychology , The Pennsylvania State University, University Park , PA , USA.|b Hershey Medical Center , Hershey , PA , USA.
authors.forename: F G
authors.initials: FG
authors.lastname: Hillary
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000639:trends*; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
keywords: Adult brain injury; alcohol use; traumatic brain injury