Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus Ohio, USA.
Violence and Injury Prevention Section, Ohio Department of Health, Columbus, Ohio, USA.
J Neurotrauma. 2020 Jul 15;37(14):1637-1644. doi: 10.1089/neu.2019.6897. Epub 2020 Apr 7.
Evidence suggests that pediatric traumatic brain injury (TBI) may be causally related to alcohol misuse later in life; however, the nature and extent of the association has not been well described. This study examined the relationship between pediatric TBI and adult alcohol misuse in a population sample ≥20 years of age. We sought to determine (1) whether first self-reported incidence of TBI with loss of consciousness (LOC) before the age of 20 increased the risk for alcohol misuse later in life; and (2) whether sex, injury severity, and age at time of injury modified the association. We found a greater likelihood of binge but not heavy drinking for those whose first self-reported TBI with LOC occurred before the age of 20 when compared with those whose first self-reported TBI with LOC occurred later in life (28.5% vs. 20.4%, = 0.003). When limited to those with only mild TBI, the relationship to binge drinking remained significant (31.9% vs. 19.3%, < 0.001) and was evident for both males (38.4% vs. 25.6%, = 0.016) and females (20.9% vs. 12.4%, = 0.044). When controlling for sex, age, and race/ethnicity, reporting a first TBI with LOC before age 20 was associated with binge drinking only for those with mild TBI (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI] = 1.00-1.74). Results also showed that those with first TBI with LOC occurring between the ages of 10 and 19 years were more likely to binge drink as adults than those first injured earlier in life, regardless of TBI severity. Further research is needed at both the epidemiological and pre-clinical levels to better understand this relationship.
有证据表明，儿童外伤性脑损伤（TBI）可能与成年后酗酒有关；然而，这种关联的性质和程度尚未得到很好的描述。本研究在年龄在 20 岁以上的人群样本中研究了儿童 TBI 与成年期酗酒之间的关系。我们旨在确定：（1）是否在 20 岁之前首次自我报告有导致意识丧失（LOC）的 TBI 会增加成年后酗酒的风险；以及（2）性别、受伤严重程度和受伤时的年龄是否会改变这种关联。我们发现，与那些在成年后首次报告 LOC 的 TBI 相比，那些在 20 岁之前首次报告有 LOC 的 TBI 更容易出现 binge 饮酒，但不会出现重度饮酒（28.5%对 20.4%，=0.003）。当仅将那些仅有轻度 TBI 的人限制在研究范围内时，这种与 binge 饮酒的关系仍然显著（31.9%对 19.3%，<0.001），并且对男性（38.4%对 25.6%，=0.016）和女性（20.9%对 12.4%，=0.044）都有意义。当控制性别、年龄和种族/民族时，在 20 岁之前首次报告有 LOC 的 TBI 仅与轻度 TBI 者 binge 饮酒有关（调整后的比值比 [OR] = 1.32；95%置信区间 [CI] = 1.00-1.74）。结果还表明，无论 TBI 严重程度如何，那些在 10 至 19 岁之间首次发生 LOC 的 TBI 的人成年后 binge 饮酒的可能性更大。需要在流行病学和临床前水平进一步研究，以更好地理解这种关系。
