Impact of Alcohol Screening for Traumatic Brain Injury Patients Being Admitted to Neurosurgical Intensive Care Unit

Cheever, Chong; Barbosa‐Leiker, Celestina

doi:10.1097/jnn.0000000000000345

Cited by 7 publications

(6 citation statements)

References 2 publications

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“…There are few studies in Brazil relating the use of cocaine to TBI, probably due to underreporting and a lack of health policies that involve research in emergency units as a routine of care. We found that 28.7% of the patients in our study tested positive for cocaine, a higher frequency than that found by Faria, 12 which was 13.9%. In both, the use predominated in males and in young people.…”

Section: Discussioncontrasting

confidence: 60%

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Dosage of Alcohol, Cocaine and Marijuana in Patients with Moderate and Severe Traumatic Brain Trauma Attended at the Hospital of Clinics of the Federal University of Uberlândia

Dias,

Resende,

Faria

2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Introduction In Brazil, there are 125,000 hospitalizations a year for traumatic brain injuries (TBI) at a high socio-economic cost, causing serious and permanent sequelae, often associated with the use of alcohol, cocaine and marijuana. Objective to discover the epidemiological characteristics of patients with moderate and severe TBI, treated at the Emergency Room of the Hospital of Clinics of the Federal University of Uberlândia (UFU), and their association with the use of alcohol, cocaine and marijuana. Material and Methods saliva and urine samples were collected from 80 patients with moderate and severe TBI, aged ≥18 years, between September 2020 and December 2021. Research was made into the use of alcohol, cocaine and marijuana, using chromatographic immunoassay test kits. Results A total of 28 cases (35%) were positive for alcohol, 22 cases for marijuana (27.5%) and 23 cases for cocaine (28.7%). The average age was 41 years old, with a predominance between 20 to 49 years old and of the male sex (90%). Accidents occurred mainly at night (52.5%) and on weekdays (65%). The most frequent cause of accident was transport (53.8%), followed by falls (22.5%) and aggression (16.2%). Of the transport accidents, motorcycle and automobiles accidents predominated (28.75%). Overall mortality was 16.2%, with zero positive cases for alcohol, 17.4% positive for cocaine and 27.3% positive for marijuana. Conclusion we observed an association between TBI, alcohol, marijuana and cocaine, as well as an increase in cocaine and marijuana cases when compared with a study performed at this institution in 2003.

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Section: Discussioncontrasting

confidence: 60%

“…Signs such as agitation, tachycardia and hypertension can manifest in both alcohol intoxication and intracranial hypertension, which could confuse the diagnosis and delay treatment. 12…”

Section: Discussionmentioning

confidence: 99%

Dosage of Alcohol, Cocaine and Marijuana in Patients with Moderate and Severe Traumatic Brain Trauma Attended at the Hospital of Clinics of the Federal University of Uberlândia

Dias,

Resende,

Faria

2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Alcohol abuse occurs among 44% to 66% of the patients with TBI 10 . Moreover, a recent study reported that there was a systemic bias per sex and age for alcohol screening in a relatively large American dataset: patients with mild or severe injuries, midrange state of consciousness, younger patients, and women were less likely to be screened 11 . Hospital records may therefore underestimate the prevalence of alcohol intoxication among the patients with acute TBI.…”

Section: Discussionmentioning

confidence: 99%

Fatal Traumatic Brain Injuries During 13 Years of Successive Alcohol Tax Increases in Finland - A Nationwide Population-Based Registry Study

et al. 2018

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We sought to investigate how increases in alcohol taxation and changes in alcohol consumption were associated with the incidence rate of fatal traumatic brain injuries (TBI) in Finland during the years 2004-2016. Nationwide, mandatory cause of death database covering all deaths in Finland was searched for all deaths related to TBIs (ICD-10: S06.X) in persons ≥16 years of age during 2004-2016. Study period included 28,657,870 person-years and 325,514 deaths of which 12,110 were TBIrelated. Occurrence rates were standardized to European 2013 standard population. Data for alcohol consumption were obtained from the National Institute for Health and Welfare and for alcohol taxation from Ministry of Finance, Finland. Standardized incidence rate of TBI-related death was 22.0 (95% CI 21.61-22.38) per 100,000 person-years. Overall alcohol consumption decreased on average by 1.2% annually. Concurrently, the overall incidence rate of fatal TBIs decreased by 4.1% annually (by 4.3% in men and 2.4% in women). There was an association between overall alcohol consumption and TBI-related mortality rate (p < 0.001). Tax-rate increases of all beverage types were associated with decreased incidence rate of TBI-related death in men (p < 0.001), in women (p < 0.036) and overall (p < 0.001). In this population-based study, we report that during 13 years of successive alcohol tax increases, overall alcohol consumption has decreased in parallel with a reduction in the incidence rate of fatal TBIs in Finland.Traumatic brain injury (TBI) is a substantial global health problem and a frequent cause of injury-related death 1,2 . The US Centers for Disease Control and Prevention (CDC) has reported a population-based TBI-related mortality rate of 17.1 per 100,000 person-years in 2010 3 , while in Europe, a pooled mortality rate of 11.7 per 100,000 person-years in 2012 has been reported 2 . Up to half of the patients who sustain TBI are intoxicated with ethanol at the time of injury [4][5][6] .Finnish alcohol control has been based on three factors: a strict state-controlled availability of alcohol, a monopoly on alcohol production and trade, and high alcohol beverage prices. Since Finland joined the EU in 1995, the system has partially dissolved. In 2004, the excise tax on alcoholic beverages was reduced markedly and alcoholic beverage prices declined by 33% with the most pronounced relative price reduction in strong alcoholic beverages. This lead to a 10% increase in overall alcohol consumption 7 . In Northern Finland, alcohol-related fatal TBIs increased among middle-aged people in 2006-2007 compared to 1999, while the total number of fatal TBIs remained unchanged 8 . To reduce health hazards, swift increases in alcohol taxes were subsequently undertaken with a focus on strong alcohol taxation. By 2016, overall alcohol taxation had reached almost the same level it had

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“…44 Systemic biases have also been found in determining which patients are tested for BAC, which may have caused us to miss some patients on initial presentation. 45 Other patient care outcomes besides hospital admission, such as alcohol withdrawal symptoms and poor surgical outcomes, may impact patient management but were not available in our databases.…”

Section: Limitationsmentioning

confidence: 99%

“… 44 Systemic biases have also been found in determining which patients are tested for BAC, which may have caused us to miss some patients on initial presentation. 45 …”

Section: Limitationsmentioning

confidence: 99%

Association of Blood Alcohol and Alcohol Use Disorders with Emergency Department Disposition of Trauma Patients

Hoonpongsimanont

Ghanem

Sahota

et al. 2022

WestJEM

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Introduction: Trauma patients who present to the emergency department (ED) intoxicated or with an alcohol use disorder (AUD) undergo more procedures and have an increased risk of developing complications. However, how AUD and blood alcohol concentration (BAC) impact a trauma patient’s disposition from the ED remains inconclusive. In this study we aimed to identify the associations between positive BAC or an AUD with admission to the hospital, including the intensive care unit (ICU). Methods: This was a retrospective study analyzing data from 2010–2018 at a university-based, Level I trauma ED. Included in the study were 4,699 adult trauma patients who completed the Alcohol Use Disorders Identification Test (AUDIT) and had blood alcohol content test results. Results: Positive BAC was associated with hospital admission and ICU admission after adjusting for injury severity score (ISS) (odds ratio 1.5 and 1.3, respectively). The AUDIT was only correlated with hospital and ICU admission in patients with ISS of 1 to 15. By increasing risk of AUD (low, moderate, high, and likely alcohol dependent) the proportion of ICU admissions rose from 29.3% to 37.3%, 40.0% and 42.0% (P <0.01). The results did not change significantly by adjustment for the age of patients. Conclusion: BAC is associated with increasing ED disposition to the hospital or ICU. Furthermore, self-reported alcohol use was associated with an increased risk of hospital or ICU admission in patients with minor or moderate injuries. Further studies to determine viable options to decrease admission rates in these patients are warranted.

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Impact of Alcohol Screening for Traumatic Brain Injury Patients Being Admitted to Neurosurgical Intensive Care Unit

Cited by 7 publications

References 2 publications

Dosage of Alcohol, Cocaine and Marijuana in Patients with Moderate and Severe Traumatic Brain Trauma Attended at the Hospital of Clinics of the Federal University of Uberlândia

Dosage of Alcohol, Cocaine and Marijuana in Patients with Moderate and Severe Traumatic Brain Trauma Attended at the Hospital of Clinics of the Federal University of Uberlândia

Fatal Traumatic Brain Injuries During 13 Years of Successive Alcohol Tax Increases in Finland - A Nationwide Population-Based Registry Study

Association of Blood Alcohol and Alcohol Use Disorders with Emergency Department Disposition of Trauma Patients

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