Alcohol-Intoxicated Patients With Blunt Trauma and Head Injuries Have Better Outcomes Than Sober Patients

Kazuhiko Takagi; Daizoh Saitoh; Koshi Nakagawa; Hironori Inoue; Hidekazu Takeuchi; Hiroshi Takyu; Hideharu Tanaka

doi:10.7759/cureus.63044

Alcohol-Intoxicated Patients With Blunt Trauma and Head Injuries Have Better Outcomes Than Sober Patients

Cureus. 2024 Jun 24;16(6):e63044. doi: 10.7759/cureus.63044. eCollection 2024 Jun.

Authors

Kazuhiko Takagi^{1

2}, Daizoh Saitoh¹, Koshi Nakagawa³, Hironori Inoue¹, Hidekazu Takeuchi¹, Hiroshi Takyu¹, Hideharu Tanaka¹

Affiliations

¹ Department of Emergency Medical System, Graduate School, Kokushikan University, Tokyo, JPN.
² Department of Paramedicine, Shinjuku Fire Station, Tokyo Fire Department, Tokyo, JPN.
³ Department of Integrated Science and Engineering for Sustainable Societies, Faculty of Science and Engineering, Chuo University, Tokyo, JPN.

Abstract

Background: Although alcohol-intoxicated patients have difficulties evaluating their consciousness level and being transported prehospital, there is some evidence that the survival outcomes for alcohol-intoxicated patients with head injuries are better. The present study evaluated whether the survival and brain function outcomes in alcohol-intoxicated trauma patients with head injuries were better than those in sober patients using the Japan Trauma Data Bank (JTDB), a nationwide trauma registry in Japan.

Methods: The 17,823 patients with blunt trauma, including head injuries, who were registered in the JTDB database between January 2019 and December 2021 were retrospectively analyzed. Logistic regression analyses were performed for in-hospital survival in patients with blunt trauma, including those with head injuries, and for good brain function based on the Glasgow outcome scale (GOS) in patients with only head injuries. Survival rates by head injury score using the abbreviated injury scale (AIS) 2008 or injury severity score (ISS) categories were compared between drinking and nondrinking groups.

Results: Drinking significantly affected survival (odds ratio 1.800, p<0.001) and good brain function (odds ratio 1.546, p<0.001), as indicated by logistic regression analysis using head injuries alone or blunt multisite trauma (including head injuries), respectively. According to analyses by the ISS category or head AIS score, there were significant differences between the drinking and non-drinking groups in several categories (ISS 9-15, 16-24, and 25-40 and AIS 3 and 5) regarding survival rates with blunt trauma, including head injuries, or good GOS rates with head injuries alone.

Conclusions: The survival rates for blunt trauma, including head injuries, and the prognosis for brain function based on the GOS were better in the drinking group than in the control group for cases with head injuries alone. A multivariate analysis also showed that alcohol consumption was significantly associated with better outcomes.

Keywords: drinking alcohol; glasgow outcome scale; head injury; nationwide trauma registry; survival.