• Ali Salim, Eric J Ley, H Gill Cryer, Daniel R Margulies, Emily Ramicone, and Areti Tillou.
• Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. ali.salim@cshs.org
• Arch Surg. 2009 Sep 1;144(9):865-71.

HypothesisEthanol exposure is associated with decreased mortality in patients with moderate to severe traumatic brain injury.DesignRetrospective database review.SettingTrauma centers contributing to the National Trauma Data Bank (NTDB).PatientsVersion 6.2 of the NTDB (2000-2005) was queried for all patients with moderate to severe traumatic brain injury (head Abbreviated Injury Score > or =3) and ethanol levels measured on admission. Demographics and outcomes were compared between patients with traumatic brain injuries with and without ethanol in their blood. Logistic regression analysis was used to investigate the relationship between mortality and ethanol.Main Outcome MeasuresMortality and complications.ResultsA total of 38 019 patients with severe traumatic brain injuries were evaluated. Thirty-eight percent tested positive for ethanol. Ethanol-positive patients were younger (mean [SD], 37.7 [15.1] vs 44.1 [22.0] years, P < .001), had a lower Injury Severity Score (22.3 [10.0] vs 23.0 [10.3], P < .001), and a lower Glasgow Coma Scale score (10.0 [5.1] vs 11.0 [4.9], P < .001) compared with their ethanol-negative counterparts. After logistic regression analysis, ethanol was associated with reduced mortality (adjusted odds ratio, 0.88; 95% confidence interval, 0.80-0.96; P = .005) and higher complications (adjusted odds ratio, 1.24; 95% confidence interval, 1.15-1.33; P < .001).ConclusionsSerum ethanol is independently associated with decreased mortality in patients with moderate to severe head injuries. Additional research is warranted to investigate the potential therapeutic implications of this association.

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