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Alcohol Intoxication and Glasgow Coma Scale Scores in Patients with Head Trauma

Journal of Trauma and Injury 2020년 33권 4호 p.227 ~ 235
박지수, 박태진, 고정인, 여운형,
소속 상세정보
박지수 ( Park Ji-Soo ) - National Medical Center Department of Emergency Medicine
박태진 ( Park Tae-Jin ) - National Medical Center Department of Emergency Medicine
고정인 ( Ko Jung-In ) - National Medical Center Department of Emergency Medicine
여운형 ( Yeo Woon-Hyung ) - Seongnam Citizens Medical Center Department of Emergency Medicine

Abstract


Purpose: Alcohol intoxication is commonly associated with traumatic brain injury (TBI), but the influence of alcohol on the Glasgow Coma Scale (GCS) score remains unclear. This study investigates the effects of blood alcohol concentration (BAC) on the GCS score in head trauma patients with alcohol intoxication.

Methods: In total, 369 head trauma patients with alcohol intoxication in a 1-year period were retrospectively analyzed. The patients underwent head computed tomography and had a BAC ≥80 mg/dL. Patients were divided into TBI and non-TBI groups. Brain injury severity was further classified using the head Abbreviated Injury Score (AIS). The effects according to 5 BAC groups were examined.

Results: The TBI group consisted of 64 patients (16.2%). The mean BAC was significantly higher in the non-TBI group (293.4±87.3 mg/dL) than in the TBI group (242.8±89.9 mg/dL). The mean GCS score was significantly lower in the TBI group (10.3±4.6) than in the non-TBI group (13.0±2.5). A higher BAC showed a significant association with a lower mean GCS score in the TBI group, but not in the non-TBI group. Above ≥150 mg/dL, higher BACs showed significant odds ratios for a lower GCS score.

Conclusions: The influence of alcohol in patients with head trauma depended on the presence of a brain injury. An association between a higher BAC and a lower GCS score was only observed in patients with TBI. Therefore, if a severe brain injury is suspected based on a GCS evaluation in patients with alcohol intoxication, prompt diagnosis and intensive care should be performed without delay.

키워드

Alcohols; Traumatic brain injury; Glasgow Coma Scale; Abbreviated Injury Scale

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