Alcohol's influence on outcome from head trauma

Introductions: The influence of acute alcohol intonation (AAI) in the outcome of head trauma has been controveniaL In this retrospective analysis we evaluate the influence of AAI in the outcome of moderate and severe head injury. Methods: Blunt trauma patients with radiographie evidence of intracranial injury and no abdominal injury, admitted for > 48 h. between 1/1/89 and 6/30/92, were included AAI+ and AAI- patients were compared with regard to the following outcomes: mortality rate; infectious complications; pneumonia; length of stay, ICU stay, ventilator days; TPN days. Control variables were: age; admission systolic BP; lowest first 5-hr BP; first-day fluid and blood requirement; ISS; MISS (1SS-GCSA amnestt component); leg; pelvic and. spinal fractures; hemo/pneumothorax; lung contusion; and type of brain injury. Variables highly associated with AAI were included in multiple regression models with mortality, infections and pneumonia as outcome. Reute: 1031 patients (AAI-, 628; AA1+. 403) were included. Table shows regression analyses excluding type of brain injury. In other model including type of brain injury with mortality as outcome, variables and their odd ratios were as follows: subdural hrmatoma (2.4), brain edema (4J), cerebral hemorrhage (3.3), brain infarction (24.7), shear injury (4.0), brain stem injury (3.0), age (6.0) and fluids (4.4). AAI, epidural hematoma, brain contusion, subanchnoid hemorrhage and brain laceration did not reach statistical significance. GmchuiM: Acute alcohol intoxication is not associated with increased mortality in head trauma patients. Rates of infection and pneumonia were higher in AAI patients. Age, initial fluid resuscitation requiiemeia and type of brain injury are ehe best predictors of outcome. MORTALITY INFECTIONS PNEUMONIA Age>SO 4.0l 1.36 N§ Alcohol + NS A49 1 42 24h fluids > 6 liters 354 1 50 1 84 MISS 1 02 0t 1 05.