Alcohol consumption, blood alcohol concentration level and guideline compliance in hospital referred patients with minimal, mild and moderate head injuries

The aims of this study were to investigate to what extent the head injury population is under the influence of alcohol, and to evaluate whether the physicians' compliance to the guidelines is affected when patients are influenced by alcohol.This study included adult patients (≥15 years) referred to a Norwegian University Hospital with minimal, mild and moderate head injuries classified according to the Head Injury Severity Scale (HISS). Information on alcohol consumption was recorded, and in most of these patients blood alcohol concentration (BAC) was measured. Compliance with the abovementioned guidelines was registered.The study includes 860 patients. 35.8% of the patients had consumed alcohol, and 92.1% of these patients had a BAC ≥ 1.00‰. Young age, male gender, trauma occurring during the weekends, mild and moderate head injuries were independent factors significantly associated with being under the influence of alcohol. Guideline compliance was 60.5%, and over-triage was the main violation. The guideline compliance showed no significant correlation to alcohol consumption or to BAC-level.This study confirms that alcohol consumption is common among patients with head injuries. The physicians' guideline compliance was not affected by the patients' alcohol consumption, and alcohol influence could therefore not explain the low guideline compliance.Traumatic brain injury (TBI) is the most common cause of death and permanent disability in trauma patients [1-3]. The incidence of TBI varies between different countries and studies [4]. The incidence for hospital referred and fatal TBIs in Europe and the United States is reported to be in the range of 83.3 - 403/100 000 and 15-18/100 000, respectively [3,5-8]. Various studies have shown that 16 - 51% of the patients admitted for TBIs are under the influence of alcohol [9-12].In year 2000 the Scandinavian Neurotrauma Committee (SNC) published guidelines with regards to safe and cost-effective management of minimal, mild a