OBJECTIVE:To examine (a) ethnic differences in blood alcohol level (BAL) and preinjury chronic alcohol use (PI-ETOH) within a severe closed head injury (CHI) sample and (b) the main and interaction effects of BAL, PI-ETOH, and ethnicity on functional outcome following severe CHI. PARTICIPANTS:A total of 434 Hispanic, Anglo-Caucasian, and African-American individuals with severe CHI. DESIGN:Retrospective cohort study. SETTING:Consecutive admissions to a level 1 trauma center. MAIN MEASURES:After admission to the trauma center, BAL was collected for each patient. Additional information regarding PI-ETOH was collected in a subset of patients (N = 116). Functional outcome was measured using the Disability Rating Scale (DRS) at 6 months after injury. RESULTS:A one-way analysis of variance revealed ethnic differences in mean BAL. Hierarchical multiple regression indicated that BAL did not predict DRS outcomes after controlling for pertinent covariates. An interaction effect between PI-ETOH and ethnicity was observed, such that presence of chronic alcohol use predicted worse functional outcome for Anglo-Caucasians and African-Americans, but more favorable outcome for Hispanics. CONCLUSIONS:Ethnic differences in BALs within our severe traumatic brain injury sample mirrored ethnic drinking patterns observed in the general population, with Hispanics having the highest BALs. A paradoxical relationship between PI-ETOH and functional outcome was observed for Hispanics.

译文

目的:研究(a)重度闭合性颅脑损伤(CHI)样本中血液酒精水平(BAL)和损伤前慢性饮酒(PI-ETOH)的种族差异,以及(b)BAL,PI-BAL的主要作用和相互作用严重的CHI后,ETOH和种族对功能结局的影响。
参与者:共有434名患有严重CHI的西班牙裔,盎格鲁-高加索人和非裔美国人。
设计:回顾性队列研究。
地点:1级创伤中心连续入院。
主要指标:入院创伤中心后,为每位患者收集BAL。在部分患者中收集了有关PI-ETOH的其他信息(N = 116)。伤后6个月使用残疾评定量表(DRS)测量功能结局。
结果:方差的单向分析显示平均BAL的种族差异。分层多元回归分析表明,在控制了相关协变量之后,BAL并不能预测DRS的预后。观察到PI-ETOH与种族之间的相互作用,例如,长期饮酒的存在预示着盎格鲁高加索人和非裔美国人的功能性结局较差,而西班牙裔则更有利。
结论:我们严重的颅脑外伤样本中BAL的种族差异反映了在普通人群中观察到的民族饮酒模式,而西班牙裔的BAL最高。西班牙裔人观察到PI-ETOH与功能结局之间存在自相矛盾的关系。

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