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Head trauma sustained under the influence of alcohol is a predictor for future traumatic brain injury: a long‐term follow‐up study
Author(s) -
Vaaramo K.,
Puljula J.,
Tetri S.,
Juvela S.,
Hillbom M.
Publication year - 2014
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12302
Subject(s) - medicine , traumatic brain injury , head trauma , head injury , term (time) , alcohol , anesthesia , physical medicine and rehabilitation , emergency medicine , psychiatry , surgery , biochemistry , chemistry , physics , quantum mechanics
Background and purpose Hazardous drinking may result in recurrent head trauma. It was investigated whether head trauma sustained under the influence of alcohol is a predictor of future traumatic brain injury ( TBI ). Methods All subjects with head trauma ( n = 827) brought to the emergency room at Oulu University Hospital during 1999 were identified and followed up until death or the end of 2009. The N ational H ospital D ischarge R egister and hospital charts were used to identify TBI s during the follow‐up and K aplan– M eier curves and the C ox proportional hazards model were used to characterize predictors of TBI . Results During the total follow‐up of 7386 person‐years, 52/827 subjects sustained a new head trauma with TBI and the risk of TBI was significantly ( P = 0.005) higher amongst subjects who had been under the influence of alcohol at the time of the index trauma in 1999. New TBI occurred under the influence of alcohol in 30/52 cases (57.7%). An alcohol‐related index trauma [adjusted hazard ratio ( HR ) 2.51, 95% confidence interval ( CI ) 1.38–4.56, P < 0.01] and history of TBI (HR 3.39, 95% CI 1.32–8.72, P < 0.05) were independent risk factors for subsequent TBI after adjustment for sex and age. A history of harmful drinking was also a significant risk factor (adjusted HR 10.37, 95% CI 5.53–19.43, P < 0.001). In the subset of 396 patients having an index head trauma without TBI , this being alcohol related was also a significant risk factor for subsequent TBI after adjustment for sex, age and history of TBI (HR 3.54, 95% CI 1.36–9.18, P = 0.009). Conclusions Even head trauma without TBI under the influence of alcohol implies an elevated risk of subsequent TBI . A brief intervention to reduce hazardous drinking is needed to prevent TBI .