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Alcohol and Alcoholism Vol. 37, No. 3, pp. 236-240, 2002
© 2002 Medical Council on Alcohol

THE EFFECTS OF ALCOHOL ON HEAD INJURY IN THE MOTOR VEHICLE CRASH VICTIM

Rebecca M. Cunningham,*, Ronald F. Maio, Elizabeth M. Hill and Brian J. Zink

University of Michigan Medical Center, Department of Emergency Medicine, TC B134 1500 East Medical Center Drive, Ann Arbor MI 48109-0303, USA

Received 19 January 2001; first review notified 17 August 2001; accepted 24 September 2001

— The objective of this study was to determine if alcohol potentiates the severity of traumatic brain injury (TBI) in motor vehicle crash (MVC) victims, controlling for crash severity characteristics. Prior studies evaluating effects of alcohol on TBI have not accounted for severity of crash. We evaluated severity of head injury by Marshall score [a classification scale of intracranial pathology on head computed axial tomogram (CT)], and blood-alcohol concentration (BAC), while controlling for crash characteristics [traffic accident deformity score (TAD) and belt use]. Marshall scores were determined from initial CT or autopsy reports, by a neurosurgeon, and were categorized into less severe injury (<3) and more severe (>=3). Logistic regression using this variable as the outcome parameter and crash characteristics, age and BAC as predictors was done, and the odds ratio (OR) and 0.95 confidence interval (0.95 CI) calculated. Fifty-eight patients were analysed: 41% were BAC positive, 30% had a modified Marshall score of >=3. Patients with positive BAC were 2.1-fold more likely to have a more severe head injury as measured on CT scan by the Marshall scores. We suggest that alcohol potentiates severity of TBI as determined from head CT among MVC victims. Further research will be needed to substantiate this finding as well as to determine its long-term effect on clinical outcome.


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