TY  - JOUR
PY  - 2015//
TI  - The impact of blood ethanol concentration on the classification of head injury severity in traumatic brain injury
JO  - Brain injury
A1  - Rønning, Pål
A1  - Gunstad, Per Ole
A1  - Skaga, Nils-Oddvar
A1  - Langmoen, Iver Arne
A1  - Stavem, Knut
A1  - Helseth, Eirik
SP  - 1648
EP  - 1653
VL  - 29
IS  - 13-14
N2  - BACKGROUND: Traumatic brain injury (TBI) is classified into mild, moderate and severe, based on the Glasgow Coma Score (GCS). However, TBI patients are often influenced by ethanol, which in itself can attenuate the level of consciousness. This study investigated the effect of ethanol on the GCS group classification in TBI patients. <br><br>METHODS: The Oslo University Hospital trauma database was searched for all patients admitted with a head injury where the blood ethanol concentration (BEC) had been measured (n = 1004). The effect of BEC on GCS groups was analysed using multivariate ordinal logistic regression. <br><br>RESULTS: This study identified 546, 142 and 316 patients in the mild, moderate and severe groups, respectively. Increasing BEC by 1 g kg(-1) and pre-hospital intubation had OR = 1.34 and 16.34 for being in a more severe GCS group, respectively. Increasing head abbreviated injury scale (head-AIS) was significantly associated with being in a more severe GCS group. The modelled probability of detecting a head-AIS of 4 or 5 in a patient with BEC of 2.0 g kg(-1) was 20%, 38% and 65% in the mild, moderate and severe groups, respectively. <br><br>CONCLUSIONS: Increasing BEC was associated with increasing odds of being in a more severe GCS group. However, because the modelled probability of significant brain injury was high in patients with high levels of BEC, a reduced level of consciousness in intoxicated patients mandates further radiological investigations.<p />  <p>Language: en</p>
LA  - en
SN  - 0269-9052
UR  - http://dx.doi.org/10.3109/02699052.2015.1075154
ID  - ref1
ER  -