Acute Alcohol Intoxication in Patients with Mild Traumatic Brain Injury: Characteristics, Recovery and Outcome

Objectives. To investigate the incidence of acute alcohol intoxication (AAI) at the time of sustaining mild traumatic brain injury (mTBI), describe the characteristics of this intoxicated subgroup, and evaluate recovery and outcome in comparison to sober mTBI patients. Methods. Multicenter cohort study of mTBI patients (GCS score 13-15) admitted to the emergency department. We compared clinical characteristics, demographics, injury mechanism and coping style between groups. Post-concussive complaints, mood disorders and PTSD-related complaints were assessed at two weeks post- injury, and outcome using the Glasgow Outcome Scale Extended (GOSE) six months post-injury.Results. Intoxicated patients represented one-third (n=173) of our total mTBI group (n=530). Results showed significant differences between intoxicated and sober patients in gender (78% vs. 59.7% males), age (35.8 vs. 40.4 years), coping style (intoxicated patients use more self-distraction) and mechanism of injury. More injuries in the intoxicated group were sustained by falls (76,3% vs. 55,2%) and through violence (12,1% vs. 3,9%), but less by (car)collisions (9,8% vs. 32,2%) and sports accidents (0% vs 4,5%). The intoxicated group was initially assessed with a lower GCS score and had a higher hospital admission rate. However, at two weeks post-injury, intoxicated patients reported less complaints than the sober group and they had an equally good recovery at six months.Conclusions. Coping style could play a role in both the sustainment of the injury as the recovery process. We conclude that AAI in mTBI represents a characteristically different group, which has implications for prevention measures as well as the course of recovery.