Research Papers

An Investigation of Traumatic Brain Injuries and Alcohol-Related Motor Vehicle Crashes In Nova Scotia

Version 1
Date added June 30, 2016
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Category 2016 CARSP XXVI Halifax
Tags Research and Evaluation, Session 6A
Author/Auteur Jennifer Heatley
Stream/Volet Research and Evaluation

Slidedeck Presentation not available (no paper submitted)

Abstract

Background/Context: Driving under the influence of alcohol is known to increase the risk of involvement in a motor vehicle collision. The risk of sustaining a traumatic brain injury (TBI) is especially concerning due to the serious immediate and long-term consequences. Although alcohol intoxication increases ones risk of injury, data from previous have also suggested that a having positive blood alcohol concentration (BAC) is associated with lower mortality following injury in a motor vehicle crash (MVC).

Aims/Objectives: This study analyzed twelve years of data on adult patients with major TBI in Nova Scotia to investigate the relationship between increasing BAC and mortality following involvement in a MVC.

Methods/Target Group: Data were obtained from the Nova Scotia Trauma Registry (NSTP) for adult patients (> 17 years) who presented to the Nova Scotia emergency departments with major TBI (abbreviated injury score [AIS] head ≥3) between 2002-2013. The NSTR provides provincial level information involving all major traumas within Nova Scotia. Only cases with an anatomic injury resulting from a transfer of energy (mechanical, chemical or thermal) due to an appropriate mechanism and meet specific criteria are considered “major trauma”. BAC was categorized as negative, 0.1-17.3 mmol/L and ≥17.4mmol/L, which is the legal positive alcohol limit in Canada. The primary outcome measures were mortality and acute length of stay (LOS).

Results/Activities: During the twelve-year study period, there were 4152 patients with major TBI that resulted from a blunt or penetrating trauma. Of these, 1253 cases (31%) were the result of involvement in a MVC. Nearly two thirds (64%) of TBI patients involved in a MVC had their BAC tested. Of patients who were tested, 53% were BAC negative, 9% had BAC 0.1-17.3 mmol/L, and 39% were found to be legally intoxicated (BAC ≥17.4 mmol/L). The mean age of TBI patients with BAC over the legal limit was 34±13 years, and most of these patients were male (88%). When assessed by their level of intoxication, the acute LOS for the BAC negative group was 63±48 days and 61±44 days for the group with BAC between 0.1-17.3 mmol/L. LOS was 71±49 days for the group with BAC ≥17.4mmol/L. Mortality was 56% in the BAC negative group, 49% in the BAC 0.1-17.3 mmol/L group, and 53% in the legally intoxicated patient group.

Discussion/Deliverables: Outcome measures of LOS and Mortality associated with Alcohol positive MVC's and TBI provide mixed results . Although LOS is highest for the higher BAC levels, LOS is similar for the BAC negative and the lower alcohol levels. Mortality is high for Alcohol related TBI, with highest mortality being found in the alcohol negative group and lowest mortality in the lower alcohol level group . Mortality increases with increasing alcohol levels , but remains less than the alcohol negative group.

Conclusions: Significant TBI and mortality is attributable to positive BAC and MVC in Nova Scotia. Young males comprise the majority of patients who suffer alcohol related TBI and MVC's. This study indicated the need for targeted injury prevention and enforcement initiatives for young males, alcohol and motor vehicle use.

Jennifer Heatley