Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand.
Emergency Department, Hutt Valley Hospital, Lower Hutt, New Zealand.
Emerg Med Australas. 2021 Aug;33(4):718-727. doi: 10.1111/1742-6723.13726. Epub 2021 Jan 26.
There is limited research from Australasian EDs describing the demographic make-up, injury severity and impact of alcohol in patients requiring computed tomography (CT) for suspected traumatic brain injury (TBI). The present study aims to review the frequency and presenting patterns of patients who consume alcohol prior to presenting with suspected TBI.
Retrospective observational study of patients referred for head CT to exclude TBI from a major referral centre and regional ED in New Zealand, between 1 September 2018 and 31 August 2019. Comparison groups were defined as 'alcohol involved' or 'no alcohol involved'.
97/425 (22.8% [95% CI 18.3-27.4]) of included TBI presentations involved alcohol. 73/97 (75.3% [95% CI 58.6-93.5]) were male and 41/97 (42.3% [95% CI 29.3-55.2]) were aged 18-30 years. The alcohol group were more likely to report assault as the injury mechanism (19.6% [95% CI 10.8-28.4] vs 5.2% [95% CI 2.7-7.7], P < 0.05) and have Glasgow Coma Scale scores reflecting more moderate (13.5% [95% CI 5.9-21.1] vs 3.5% [95% CI 1.5-5.6]) and severe (5.6% [95% CI 0.7-10.5] vs 3.2% [95% CI 1.2-5.2] TBI. Presentation times post-injury were delayed compared to the no alcohol group (3.4 h [interquartile range 1.9-14.8] vs 2.8 h [interquartile range 1.8-6.6], P < 0.05).
One quarter of patients with suspected TBI had consumed alcohol prior to their injury. Predominantly, those affected were young males who reported higher rates of assault; however, alcohol use was recorded in all age groups and sex. Alcohol-affected patients presented later, potentially delaying time to diagnosis. The present study supports the call for public health interventions that aim to reduce alcohol misuse.
在澳大利亚急诊医学中，关于因疑似创伤性脑损伤（TBI）而接受计算机断层扫描（CT）检查的患者的人口统计学特征、损伤严重程度和酒精影响的研究有限。本研究旨在回顾在疑似 TBI 就诊前有饮酒史的患者的频率和就诊模式。
这是一项回顾性观察性研究，对新西兰一家主要转诊中心和地区急诊室在 2018 年 9 月 1 日至 2019 年 8 月 31 日期间因疑似 TBI 而接受头部 CT 检查的患者进行研究。比较组定义为“有酒精摄入”或“无酒精摄入”。
425 例 TBI 患者中有 97 例（22.8%[95%CI 18.3-27.4%]）有酒精摄入。97 例中有 73 例（75.3%[95%CI 58.6-93.5%]）为男性，41 例（42.3%[95%CI 29.3-55.2%]）年龄在 18-30 岁之间。与无酒精组相比，酒精组更有可能报告因袭击而受伤（19.6%[95%CI 10.8-28.4%] vs 5.2%[95%CI 2.7-7.7%]，P<0.05），格拉斯哥昏迷量表评分反映出更中度（13.5%[95%CI 5.9-21.1%] vs 3.5%[95%CI 1.5-5.6%]）和重度（5.6%[95%CI 0.7-10.5%] vs 3.2%[95%CI 1.2-5.2%]TBI。与无酒精组相比，受伤后就诊时间延迟（3.4 小时[四分位间距 1.9-14.8] vs 2.8 小时[四分位间距 1.8-6.6]，P<0.05）。
四分之一疑似 TBI 的患者在受伤前有饮酒史。受影响的主要是年轻男性，他们报告的袭击率更高；然而，所有年龄组和性别都记录到了酒精摄入。酒精组患者就诊时间较晚，可能会延迟诊断时间。本研究支持呼吁采取公共卫生干预措施，以减少酒精滥用。
