Patients have a greater chance of dying in-hospital if they have a high blood alcohol concentration (BAC) than if their BAC was zero. However, patients with a low to moderate blood alcohol concentration were less likely to die in-hospital than patients with no alcohol in their blood.
The study, published today in the Archives of Surgery, shows that almost 50% of patients with severe traumatic brain injury and high blood alcohol concentration will succumb to their injuries. It indicates that when blood alcohol levels are high, the brain injury becomes more difficult to manage. One reason is that not all brain injury occurs immediately, but evolves with time due to secondary brain injury. High concentrations of alcohol impede the resuscitation of patients with severe brain injury. Paradoxically, however, low concentrations of alcohol may improve outcome from brain injury.
"Low concentrations of alcohol may have the ability to reduce secondary brain injury and may therefore improve brain injury survival," says Dr. Tien. "However, the study only describes the effect of alcohol on the brain after injury occurs and I'd like to stress that alcohol remains the leading cause of preventable trauma deaths and dramatically increases the likelihood of injury and fatal injury." Between 30% to 50% of all patients hospitalized with trauma are intoxicated at the time of injury.
The study looked at data collected between January 1, 1988 to December 31, 2003 to identify patients with severe brain injury from blunt head trauma (resulting from a motor vehicle collision, for example.) 1158 eligible patients were analyzed at three BAC levels: no blood alcohol concentration (0mg/dL); low to moderate blood alcohol concentration (less than 230mg/dL) and high blood alcohol concentration (230mg/dL or greater).
The result of this study suggests that alcohol may have a role as a resuscitation fluid in well- resuscitated patients with severe brain injury. However, further study will be required to confirm this effect of alcohol on brain injury outcomes.
By Sunnybrook Health Sciences Centre
Posted December 19th, 2006 by Armen Hareyan
