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April 2010

No Cheers Yet for Ethanol in Traumatic Brain Injury—Reply

Author Affiliations

Author Affiliations: Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California.

Arch Surg. 2010;145(4):403. doi:10.1001/archsurg.2010.26

In reply

We thank Drs Bourdeaux and Marsh for their interest in our study that correlated serum ethanol levels to a decreased mortality after moderate to severe traumatic brain injury.1 We look forward to any future collaboration on this subject.

The association between positive ethanol and GCS score is well described. Stuke et al2 studied GCS levels in more than 55 000 patients with positive blood alcohol levels and found that the presence of alcohol did not significantly reduce the GCS score among patients with traumatic brain injury after stratification by head Abbreviated Injury Score compared with those with negative ethanol levels. Other researchers have supported these findings.3,4 Attributing reduced GCS score to alcohol intoxication in patients with traumatic brain injury may lead to delays in diagnosis and treatment.

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