Factors Affecting Outcome of Traumatic Brain Injury in Alcohol Dependence in the Absence of Intoxication: A Study from Goa

Abstract

Abstract Background: Alcohol dependence is common in certain parts of the world and it contributes to increased incidence of head injury. The effect of alcohol dependence on head injury outcome separate from intoxication has not received much attention. Aims: We evaluate the factors affecting outcome in head injury patients with a history of alcohol dependence. Methods: A prospective study of alcohol-dependent patients with head injury was conducted. The patients were treated using standard head injury protocols and information regarding duration of alcohol use was assessed with investigations relating to alcoholic liver disease. The outcome was measured up to 1 month and analyzed with respect to the factors measured. Results: The Extended Glasgow Outcome Score at 1 month was lower in patients with increasing duration of alcohol use. Increased duration of alcohol use also led to increased incidence of liver disease and coagulopathy, which independently affected the outcome negatively. Higher duration of alcohol use also resulted in increased risk of seizures and infection. Conclusions: Alcohol dependence negatively affects head injury outcome at 1 month. In addition, increased duration of alcohol use shows a linear trend with poor outcome. Although the exact mechanisms for this are not clear, detection and management of complications like coagulopathy may improve outcome.