title: Positive blood alcohol level in severe traumatic brain injury is associated with better long-term functional outcome.
abstract: To investigate the association between positive blood alcohol level (BAL) and functional outcome in patients suffering severe traumatic brain injury.
  
  
  
  The brain trauma registry of an academic trauma centre was queried for patients admitted between January 2007 and December 2011. All patients (≥ 18 years) with a neurosurgical intensive care length of stay beyond 2 days were included. Patient demographics, clinical characteristics, injury profile, laboratory test and outcomes were abstracted for analysis. Primary outcome was unfavourable functional outcome defined as Glasgow Outcome Score (GOS) ≤ 3. Multivariable regression models were used for analysis.
  
  
  
  Of the 352 patients, 39% were BAL (+) at admission. Patients with (+) BAL were significantly younger with less co-morbidities. The cohorts exhibited no significant difference in the severity of the intra-cranial injury and the use of intra-cranial monitoring or surgical interventions. Further, the groups presented no difference in in-hospital mortality (p = 0.1) or 1-year mortality (p = 0.5). There was a worse long-term functional outcome in (-) BAL patients compared to their BAL (+) counterparts after adjustment for confounders (GOS ≤ 3: AOR = 2.0, 95% CI = 1.1-3.5, p = 0.02).
  
  
  
  Positive BAL on admission is associated with a better long-term functional outcome in patients suffering severe traumatic brain injury.
authors.affiliation: a Division of Trauma and Emergency Surgery, Department of Surgery , Karolinska University Hospital , Stockholm , Sweden.|b Division of Trauma and Emergency Surgery, Department of Surgery , Orebro University Hospital , Orebro , Sweden.
authors.forename: Shahin
authors.initials: S
authors.lastname: Mohseni
authors.affiliation: c Department of Clinical Neuroscience, Section for Neurosurgery , Karolinska Institute , Stockholm , Sweden.
authors.forename: Bo-Michael
authors.initials: BM
authors.lastname: Bellander
authors.affiliation: a Division of Trauma and Emergency Surgery, Department of Surgery , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Louis
authors.initials: L
authors.lastname: Riddez
authors.affiliation: d Department of Surgery , Tartu University Hospital Department of Surgery , Tartu , Estonia.
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.affiliation: c Department of Clinical Neuroscience, Section for Neurosurgery , Karolinska Institute , Stockholm , Sweden.
authors.forename: Eric P
authors.initials: EP
authors.lastname: Thelin
mesh_terms: D000328:Adult; D000368:Aged; D000067401:Blood Alcohol Content; D000070642:Brain Injuries, Traumatic / Q000097:blood* / Q000401:mortality; D000431:Ethanol / Q000097:blood*; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D013548:Sweden
chemical_list: D000067401:Blood Alcohol Content; D000431:Ethanol
keywords: Traumatic brain injury; beta-blockade; functional outcome