Comparison of Emergency Room and Self-reported Alcohol Use in Individuals with Traumatic Brain Injury
Allison Li1, Alexa Walter1, My Duyen Lee1, Ramon Diaz-Arrastia1, Danielle Sandsmark1
1Neurology, University of Pennsylvania
Objective:
It is unclear if alcohol misuse impacts traumatic brain injury (TBI) recovery. We examined alcohol use upon hospitalization with TBI using blood alcohol content (BAC) levels and self-reported alcohol use via AUDIT-C. We investigated if Audit-C and BAC levels correlate with future outcomes.
Background:
It is not well understood whether patient’s alcohol consumption impacts outcomes after TBI. We predicted that individuals with higher self-report alcohol consumption would have high blood alcohol concentrations (BAC) upon ED evaluation and that higher alcohol use would correlate with poorer recovery.
Design/Methods:
Subjects with TBI were enrolled within 72 hours of their injury. At time of enrollment, self-reported AUDIT-C was collected. BAC levels at the time of ED evaluation were collected by chart review. AUDIT-C scores (0-12) were dichotomized: ≥4 in men and ≥3 in women indicated disordered alcohol use. BAC>80 was indicative of inebriation. The Glasgow Coma Scale-Extended (GOSE) and Satisfaction with Life Scale (SWLS) outcome measures were collected in a subset of participants (n=37) 6 months post-injury. Wilcoxon rank sum test and Pearson’s chi-squared test were used to compare groups.
Results:
147 participants with TBI (mean[SD] age: 44.0 [17.6], 68.7% male, median GCS: 15 (IQR:14-15)) were included. 22.2% of had BAC >80 when evaluated in the ED. AUDIT-C scores were positive in 40.1% of participants. When comparing BAC and self-report alcohol use, 18% of individuals with a negative AUDIT-C and 56% of patients with a positive AUDIT-C were inebriated by BAC. BAC levels were significantly different (p<0.001) by AUDIT-C category, with a positive AUDIT-C associated with higher BAC levels. There was no significant relationship between AUDIT-C and GOSE. Positive AUDIT-C was correlated with lower SWLS scores (p=0.018) indicating more dissatisfaction.
Conclusions:
Self-reported AUDIT-C aligns with inebriation upon admission for TBI patients. However, AUDIT-C and at-injury inebriation had minimal relationship with outcomes.
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