Alcohol: a risk factor for head injury

Introduction

The study objective was to determine whether there is a significant difference in the pattern and severity of injury sustained during falls in patients who have consumed alcohol and those who have not. To determine how the pattern and severity of injury correlates with the blood alcohol level (BAL).

Methods

A prospective quasi-randomised controlled study between November 2001 and July 2002. All healthy adults between 16 and 60 years old who had fallen from standing height were included. A systematic history and examination allowed calculation of injury severity scores as per the abbreviated injury scale update 1998. BALs were obtained from intoxicated patients with consent.

Results

Three hundred and fifty-one healthy adult patients were included in the study, there were 238 in the no alcohol group, 113 had consumed alcohol, and blood alcohol levels were obtained for 47 patients. The alcohol group had a higher incidence of head injuries (46 (48%) vs 22 (9%)) with a lower incidence of limb injuries (39 (39%) vs 183 (76%)) than the no alcohol group. There was a significant difference in the pattern of injury between the alcohol and no alcohol groups (χ², P < 0.001) and there was a significant difference in the injury severity scores (P < 0.001, Z-2.5). In the alcohol group, the severity and pattern correlated with the alcohol level at the time of injury. Patients with an alcohol level <200 mg/dl had mostly soft-tissue limb injuries (58%), 200–250 mg/dl mostly significant limb fractures (55%) and >250 mg/dl mostly significant head injuries (90%).

Conclusion

Alcohol-related falls are more often associated with severe craniofacial injury. The severity of both limb and head injury is greater and correlates directly with the BAL.