Research Reports - Acute alcohol intoxication in patients with mild traumatic brain injury: Characteristics, recovery and outcome

J Neurotrauma. 2015 Jul 31

Scheenen ME(1), de Koning ME(2), van der Horn HJ(3), Roks G(4), Yilmaz T(5), van
der Naalt J(6,)(7), Spikman JM(8)

A substantial number of patients (30-50%) sustains a mild traumatic brain injury
(mTBI) while they are under the influence of alcohol. An acute alcohol
intoxication (AAI) at the time of injury has been subject of research in severe
TBI, but little is known about the relation between AAI and mTBI. This study
aimed to describe the characteristics of this intoxicated subgroup and evaluate
recovery and outcome in comparison to sober mTBI patients. We included 528 mTBI
patients (Glasgow Coma Scale [GCS] score 13-15) admitted to two level 1 trauma
centers as part of a prospective follow-up study. We compared clinical
characteristics, demographics and injury mechanism between groups.
Post-concussive complaints, mood disorders and post-traumatic stress-related
complaints were assessed at two weeks post- injury, and outcome at six months
with the Glasgow Outcome Scale Extended (GOSE). 33% of the mTBI patients was
intoxicated. Results showed that the intoxicated group was younger (36 vs. 40
years, p=.001), and were more frequently of male gender (78% vs. 60%, p<.001).
The groups also differed in injury related characteristics, with intoxicated
patients more frequently sustaining falls- or violence related injuries. The
intoxicated group was assessed with a lower GCS score and had a higher hospital
admission rate. However, at two weeks post-injury, intoxicated patients reported
less complaints than the non-alcohol group and showed a better recovery at six
months (average GOSE scores 7 vs. 7.3, p=.030). We conclude that AAI in mTBI
represents a characteristically different group, which has implications for
prevention measures as well as the course of recovery.

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