Your browser doesn't support javascript.
loading
Emergency department blood alcohol level associates with injury factors and six-month outcome after uncomplicated mild traumatic brain injury.
Yue, John K; Ngwenya, Laura B; Upadhyayula, Pavan S; Deng, Hansen; Winkler, Ethan A; Burke, John F; Lee, Young M; Robinson, Caitlin K; Ferguson, Adam R; Lingsma, Hester F; Cnossen, Maryse C; Pirracchio, Romain; Korley, Frederick K; Vassar, Mary J; Yuh, Esther L; Mukherjee, Pratik; Gordon, Wayne A; Valadka, Alex B; Okonkwo, David O; Manley, Geoffrey T.
Afiliación
  • Yue JK; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Ngwenya LB; Department of Neurological Surgery, University of Cincinnati, Cincinnati, OH, USA.
  • Upadhyayula PS; Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, USA.
  • Deng H; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Winkler EA; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Burke JF; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Lee YM; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Robinson CK; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Ferguson AR; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Lingsma HF; Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Cnossen MC; Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
  • Pirracchio R; Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA; Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA.
  • Korley FK; Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
  • Vassar MJ; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
  • Yuh EL; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, San Francisco, CA, USA.
  • Mukherjee P; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, San Francisco, CA, USA.
  • Gordon WA; Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Valadka AB; Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA, USA.
  • Okonkwo DO; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
  • Manley GT; Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA. Electronic address: manleyg@neurosurg.ucsf.edu.
J Clin Neurosci ; 45: 293-298, 2017 Nov.
Article en En | MEDLINE | ID: mdl-28789959
ABSTRACT
The relationship between blood alcohol level (BAL) and mild traumatic brain injury (mTBI) remains in need of improved characterization. Adult patients suffering mTBI without intracranial pathology on computed tomography (CT) from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with emergency department (ED) Glasgow Coma Scale (GCS) 13-15 and recorded blood alcohol level (BAL) were extracted. BAL≥80-mg/dl was set as proxy for excessive use. Multivariable regression was performed for patients with six-month Glasgow Outcome Scale-Extended (GOSE; functional recovery) and Wechsler Adult Intelligence Scale Processing Speed Index Composite Score (WAIS-PSI; nonverbal processing speed), using BAL≥80-mg/dl and <80-mg/dl cohorts, adjusting for demographic/injury factors. Overall, 107 patients were aged 42.7±16.8-years, 67.3%-male, and 80.4%-Caucasian; 65.4% had BAL=0-mg/dl, 4.6% BAL<80-mg/dl, and 30.0% BAL≥80-mg/dl (range 100-440-mg/dl). BAL differed across loss of consciousness (LOC; none median 0-mg/dl [interquartile range (IQR) 0-0], <30-min 0-mg/dl [0-43], ≥30-min 224-mg/dl [50-269], unknown 108-mg/dl [0-232]; p=0.002). GCS<15 associated with higher BAL (19-mg/dl [0-204] vs. 0-mg/dl [0-20]; p=0.013). On univariate analysis, BAL≥80-mg/dl associated with less-than-full functional recovery (GOSE≤7; 38.1% vs. 11.5%; p=0.025) and lower WAIS-PSI (92.4±12.7, 30th-percentile vs. 105.1±11.7, 63rd-percentile; p<0.001). On multivariable regression BAL≥80-mg/dl demonstrated an odds ratio of 8.05 (95% CI [1.35-47.92]; p=0.022) for GOSE≤7 and an adjusted mean decrease of 8.88-points (95% CI [0.67-17.09]; p=0.035) on WAIS-PSI. Day-of-injury BAL>80-mg/dl after uncomplicated mTBI was associated with decreased GCS score and prolongation of reported LOC. BAL may be a biomarker for impaired return to baseline function and decreased nonverbal processing speed at six-months postinjury. Future confirmatory studies are needed.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inconsciencia / Recuperación de la Función / Servicio de Urgencia en Hospital / Nivel de Alcohol en Sangre / Lesiones Traumáticas del Encéfalo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Neurosci Asunto de la revista: NEUROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Inconsciencia / Recuperación de la Función / Servicio de Urgencia en Hospital / Nivel de Alcohol en Sangre / Lesiones Traumáticas del Encéfalo Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Neurosci Asunto de la revista: NEUROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Estados Unidos