Bjarkø Vera Vik, Skandsen Toril, Moen Kent Gøran, Gulati Sasha, Helseth Eirik, Nilsen Tom I L, Vik Anne
Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
World Neurosurg. 2019 Feb;122:e684-e689. doi: 10.1016/j.wneu.2018.10.122. Epub 2018 Oct 30.
Knowledge about the causes and time of injury for traumatic brain injury (TBI) is important for the development of efficient prevention policies. We aimed to study time of injury and relation to alcohol intoxication for moderate-to-severe TBI in a level 1 trauma center in Norway.
From October 2004 to September 2014, 493 consecutive patients (≥16 years) with moderate (Glasgow Coma Scale [GCS] score 9-13) and severe TBI (GCS score 3-8) were prospectively included in the Trondheim TBI Study (222 patients with moderate and 270 patients with severe TBI).
Mean age was 47 years (standard deviation 21 years). Positive blood alcohol concentration (BAC) was found in 29%, and median BAC was 41.5 mmol/L (interquartile range 28.7-54.3), equal to 1.91‰. Admissions were more frequent on Saturdays (relative risk [RR] 2.67, 95% confidence interval [CI] 1.87-3.80) and Sundays (RR 2.10, 95% CI 1.45-3.03) compared with Mondays, and positive BAC was more common on weekends than weekdays (43% vs. 16%). Furthermore, admissions were more frequent in June (RR 2.26, 95% CI 1.44-3.55), July (RR 2.07, 95% CI 1.31-3.28), and December (RR 2.07, 95% CI 1.31-3.28) compared with January. The number of patients with positive BAC was greatest in December (RR 5.75, 95% CI 1.99-16.63), and 70% of these were caused by falls.
Our findings demonstrate that moderate-to-severe TBI admissions display a clear weekly and seasonal variation and that alcohol is an important modifiable risk factor for moderate-to-severe TBI.
了解创伤性脑损伤（TBI）的病因和受伤时间对于制定有效的预防政策至关重要。我们旨在研究挪威一家一级创伤中心中重度TBI的受伤时间及其与酒精中毒的关系。
2004年10月至2014年9月，493例连续的患者（≥16岁），中度（格拉斯哥昏迷量表[GCS]评分为9 - 13）和重度TBI（GCS评分为3 - 8）被前瞻性纳入特隆赫姆TBI研究（222例中度患者和270例重度TBI患者）。
平均年龄为47岁（标准差21岁）。29%的患者血液酒精浓度（BAC）呈阳性，BAC中位数为41.5 mmol/L（四分位间距28.7 - 54.3），相当于1.91‰。与周一相比，周六（相对危险度[RR] 2.67，95%置信区间[CI] 1.87 - 3.80）和周日（RR 2.10，95% CI 1.45 - 3.03）的入院人数更多，周末BAC阳性比工作日更常见（43%对16%）。此外，与1月相比，6月（RR 2.26，95% CI 1.44 - 3.55）、7月（RR 2.07，95% CI 1.31 - 3.28）和12月（RR 2.07，95% CI 1.31 - 3.28）的入院人数更多。12月BAC阳性的患者数量最多（RR 5.75，95% CI 1.99 - 16.63），其中70%是由跌倒引起的。
我们的研究结果表明，中重度TBI入院呈现明显的每周和季节性变化趋势，并且酒精是中重度TBI的一个重要可改变风险因素。
