• Jussi Puljula, Kalle Vaaramo, Sami Tetri, Seppo Juvela, and Matti Hillbom.
• *Department of Neurology, University of Oulu and Oulu University Hospital, Oulu, Finland†Department of Neurosurgery, University of Oulu and Oulu University Hospital, Oulu, Finland‡Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland.
• Ann. Surg. 2016 Jun 1; 263 (6): 1235-9.

ObjectiveTo investigate long-term mortality for subjects with acute head trauma.BackgroundIt is not known why long-term mortality after head trauma without traumatic brain injury is elevated.MethodsAll subjects admitted to Oulu University Hospital emergency room in 1999 with an acute head trauma (n = 737) were followed up until February 2014 and compared with age and sex-matched general population controls (n = 2196). Dates and causes of death were obtained from the official Cause-of-Death Statistics. Cox proportional hazard regression models and Kaplan-Meier survival curves were used to identify predictors for alcohol-related, nonalcohol-related, and all-cause death.ResultsAlcohol-related deaths were more frequent among the subjects with head trauma (27.8%) than among the population controls (6.9%). Head trauma with or without traumatic brain injury (TBI) shortened mean life expectancy by 8.7 years and by as much as 13 years if only those without TBI were considered. The risk of alcohol-related death was 7-fold (hazard ratio 6.79; 95% confidence interval, 3.94-11.71) among subjects without TBI as compared with general population. Of all future deaths among these cases 17.1% were because of a new trauma, a significantly higher frequency (P < 0.005) than that observed in the general population (3% of all deaths). Alcohol-related cause of death was significantly more common among the subjects who were under the influence of alcohol at the time of the index trauma than among the sober subjects.ConclusionsHead trauma subjects without TBI have an elevated risk of alcohol-related death. Alcohol-related traumas are a major cause of death among these subjects.

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