Effects of alcohol on Glasgow Coma Scale score and outcome in patients with moderate and severe traumatic brain injury
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Introduction/object: Alcohol is among many clinicians assumed to be a confounding factor when evaluating the consciousness of traumatic brain injury (TBI) patients. Research findings are divergent, and the aim of this study is to measure the effects of alcohol on GCS score and outcome at 12 months in moderate and severe TBI patients. Methods: A total of 166 patients age 16 - 70 years with moderate and severe TBI admitted to Trondheim University Hospital during a 5-year period were included in this prospective cohort study. Only patients with measured blood alcohol concentrations (BAC) values were included. The effects of alcohol on GCS score and Glasgow Outcome Scale Extended at 12 months were examined with ordinal logistic regression analysis. Rotterdam CT score was used to adjust for brain injury severity. Results: Increasing BAC values were shown to significantly reduce the GCS scores in moderate and severe TBI patients, OR 1.58 (1.2 – 2.08) p=0.001. When we stratified patients on injury severity, increasing BAC values were associated with a reduction in the GCS scores among patients with ”minor CT findings” (Rotterdam CT scores 1-3, OR 1.87 (1.33 -2.59) p<0.001). No such relationship was found in those with “major CT findings” (Rotterdam CT scores 4- 6, OR 1.2 (0.72-2.01), p=0.48). Alcohol intoxication at the time of injury did not have a significant effect on outcome measured in GOSE score, OR 0.92 (0.69 – 1.22) p=0.564. Conclusions: There is a clinical significant reduction in the GCS score with increasing BAC values in patients with minor CT finding. Alcohol intoxication at the time of injury did not affect outcome.