Quantification of Alcohol Dehydrogenase Concentration for Traumatic Brain Injury in Alcohol-intoxicated Patients as a Predictor of Severity and Prognosis
DOI:
https://doi.org/10.3889/oamjms.2021.5845Keywords:
Alcohol-intoxicated patients, Alcohol dehydrogenase, PrognosisAbstract
BACKGROUND: Traumatic brain injury (TBI) stills the leading cause of public health problem and disabilities in many countries, especially in lower-middle-income countries. Motor vehicle crashes, especially motorized two-wheeler riders, are the major cause of TBI, followed by fall and assault. During 2013–2014, a total of 2108 TBI cases (65.4% of them being caused by motor vehicle crashes) were documented in the Emergency Unit of Dr. Hasan Sadikin Hospital (RSHS) Bandung. Among these, 30.7% of cases were categorized as moderate and severe TBI, with a mortality rate of 29.2%. Half of the cases arrived at RSHS within 6 h and 14.0% of these cases were alcohol-intoxicated. Individuals with low activity of alcohol-metabolizing enzymes have low tolerance to alcohol and are therefore rapidly intoxicated, making them more susceptible to more serious injuries from motor vehicle crashes.
METHODS: A prospective study was designed by consecutive sampling from January to August 2017 to review 30 intoxicated patients with TBI on hospital admission by measuring their serum alcohol dehydrogenase (ADH) concentration using an ELISA and then correlated it with the severity, type of TBI lesions, and the outcome.
RESULTS: Demonstrated an ADH level of l d0.24 ng/ml in patients with TBI with a history of alcohol intoxication, which statistically correlated with lower initial Glasgow coma scale (GCS) scores on admission by approximately 6.53 times (p < 0.001), thus increasing the risk of developing multiple lesions by 3.98 times (p = 0.029) and worse outcomes by 5.27 times (p = 0.003), but it did not correlate with length of stay (p = 0.392).
CONCLUSIONS: ADH concentrations in intoxicated TBI patients can be taken into consideration to decide about the therapeutic action and further informed consent to the family.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Maas AIR, Stocchetti N, Bullock R. Moderate and severe traumatic brain injury in adults. Lancet Neurol. 2008;7(8):728- 41. https://doi.org/10.1016/s1474-4422(08)70164-9 PMid:18635021 DOI: https://doi.org/10.1016/S1474-4422(08)70164-9
Harris AH, Lembke A, Henderson P, Gupta S, Moos R, Bradley KA. Risk of future trauma based on alcohol screening scores: A two-year prospective cohort study among US veterans. Addict Sci Clin Pract. 2012;7(1):6. https://doi.org/10.1186/1940-0640-7-6 PMid:22966411 DOI: https://doi.org/10.1186/1940-0640-7-6
O’Connor LR, Ruiz RAL. Alcohol and hospitalized road traffic injuries in the Philippines. Yale J Biol Med. 2014;87(3):307-19. PMid:25191146
Opreanu R, Kuhn D, Basson M. NIH public access the influence of alcohol on mortality in TBI. J Am Coll Surg. 2012;29(6):997-1007. PMid:20510810 DOI: https://doi.org/10.1016/j.jamcollsurg.2010.01.036
World Health Organization. Global Status Report On Road Safety 2013: Supporting a Decade of Action. Geneva: World Health Organization; 2013.
Raj R, Skrifvars MB, Kivisaari R, Hernesniemi J, Lappalainen J, Siironen J. Acute alcohol intoxication and long-term outcome in patients with traumatic brain injury. J Neurotrauma. 2015;32(2):95-100. https://doi.org/10.1089/neu.2014.3488 PMid:25010885 DOI: https://doi.org/10.1089/neu.2014.3488
Zamzami NM, Fuadi I, Nawawi M. Incidence Rate and Outcome of Brain Injury at Dr. Hasan Sadikin Hospital, Bandung, 2008- 2010. Jurnal Neuroanestesia Indonesia 2013;2:6.
Faried A, Bachani AM, Sendjaja AN, Hung YW, Arifin MZ. Characteristics of moderate and severe traumatic brain injury of motorcycle crashes in Bandung, Indonesia. World Neurosurg. 2017;100:195-200. https://doi.org/10.1016/j.wneu.2016.12.133 DOI: https://doi.org/10.1016/j.wneu.2016.12.133
Enkhjargal Ts, Gantuya P, Hishigbuyan D, Sodnomtseren B. Blood levels of alcohol dehydrogenase and aldehydedehydrogenase. Mong Med Sci J. 2013;164(2):7-10.
Zador PL. Alcohol-related relative risk of fatal driver injuries in relation to driver age and sex. J Stud Alcohol. 1991;52(4):302- 10. https://doi.org/10.15288/jsa.1991.52.302 PMid:1875701 DOI: https://doi.org/10.15288/jsa.1991.52.302
Keall MD, Frith WJ, Patterson TL. The influence of alcohol, age and number of passengers on the night-time risk of driver fatal injury in New Zealand. Accident Anal. Prev. 2004;36(1):49-61. https://doi.org/10.1016/s0001-4575(02)00114-8 PMid:14572827 DOI: https://doi.org/10.1016/S0001-4575(02)00114-8
National Highway Traffic Safety Administration. Traffic Safety Facts, 2000: Motorcycles. Washington, DC: National Highway Traffic Safety Administration; 2001. https://doi.org/10.1037/ e478152008-001
Vukovic J, Modun D, Markovic D, Sutlovic D. Comparison of breath and blood alcohol concentrations in a controlled drinking study. J Subst Abuse Alcohol. 2015;3(2):1029.
Bühler R, Von Wartburg JP. Quantitation of alcohol dehydrogenase in human tissue and serum by an enzyme-linked immunosorbent assay (ELISA). Alcohol Clin Exp Res. 1982;6(4):506-11. https://doi.org/10.1111/j.1530-0277.1982. tb05014.x PMid:6758622 DOI: https://doi.org/10.1111/j.1530-0277.1982.tb05014.x
Cederbaum AI. Alcohol metabolism. Clin Liver Dis. 2012;16(4):667-85. PMid:23101976 DOI: https://doi.org/10.1016/j.cld.2012.08.002
Downloads
Published
How to Cite
License
Copyright (c) 2020 Muhammad Z. Arifin, David Atmaja, Ahmad Faried (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
