We performed a retrospective study of 2484 consecutive patients with mild head injury (Glasgow Coma Scale score 13-15) who were seen during a period of 18 months. Of these, 2351 (94.6%) patients scored 15 points, 88 (3.5%) scored 14 points and 45 (1.3%) 13 points. A multivariate analysis showed that advanced age, a lower GCS (13-14) and the presence of skull fracture, and focal signs, significantly increased the incidence of abnormal computed tomography (CT) findings. By contrast, the gender, the mechanism of injury, the occurrence of initial loss of consciousness, posttraumatic amnesia and coagulation disorders did not significantly increase the incidence of abnormal CT findings. Patients with 13-14 GCS had a significantly higher incidence of initial loss of consciousness, of skull fracture, abnormal CT findings, need for hospital admission, delayed neurological deterioration and need for operation than patients with a GCS of 15. Thus, we suggest separating patients with a GCS of 13-14 into a different category and recommend performing CT in all those not improving within 4-6 h of injury. Such a policy makes skull radiography unnecessary in this subgroup. By contrast, skull radiographs may be useful for the triage of patients with a GCS of 15 that represent most of the mild head injury cases; radiographs should be obtained in patients presenting with initial loss of consciousness or posttraumatic amnesia (27.9% of the total cases) as these two findings were associated with a significantly higher incidence of fracture. Patients without these two findings (72.1% of the cases) showed a very low incidence of skull fracture (0.9% in this study) and may be discharged home with a warning sheet.
Introduction Alcohol and tobacco are commonly used together. Social influences within online social networking platforms contribute to youth and young adult substance use behaviors. This study used a sample of alcohol- and tobacco-related tweets to evaluate: (1) sentiment toward co-use of alcohol and tobacco, (2) increased susceptibility to tobacco use when consuming alcohol, and (3) the role of alcohol in contributing to a failed attempt to quit tobacco use. Methods Data were collected from the Twitter API from 2019-01-01 through 2019-12-31 using tobacco-related keywords (e.g., vape, ecig, smoking, juul*) and alcohol-related filters (e.g., drunk, blackout*). A total of 78,235 tweets were collected, from which a random subsample (n = 1,564) was drawn for coding. Cohen’s Kappa values ranged from 0.66-0.99. Results Most tweets were pro co-use of alcohol and tobacco (75%). One of every ten tweets reported increased susceptibility to tobacco use when intoxicated. Non-regular tobacco users reported cravings for and tobacco use when consuming alcohol despite disliking tobacco use factors such as the taste, smell, and/or negative health effects. Regular tobacco users reported using markedly higher quantities of tobacco when intoxicated. Individuals discussed the role of alcohol undermining tobacco cessation attempts less often (2.0%), though some who had quit smoking for prolonged periods of time reported reinitiating tobacco use during acute intoxication episodes. Conclusions Tobacco cessation interventions may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts. Implications Sentiment toward co-use of alcohol and tobacco on Twitter is largely positive. Individuals reported regret about using tobacco, or using more than intended, when intoxicated. Those who had quit smoking or vaping for prolonged periods of time reported reinitiating tobacco use when consuming alcohol. While social media-based tobacco cessation interventions like the Truth Initiative’s “Ditch the Juul” campaign demonstrate potential to change tobacco use behaviors, these campaigns may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.