Blood alcohol concentration as a determinant of outcomes after traumatic spinal cord injury

Background Pre‐clinical studies indicate a potential detrimental effect of ethanol on tissue sparing and locomotor recovery in animal models of spinal cord injury (SCI). Given this, an examination of whether blood alcohol concentration (BAC) is a potential determinant of survival and neurological and functional recovery after acute traumatic SCI was carried out. Methods All patients who were enrolled in the Third National Spinal Cord Injury Study (NASCIS‐3) were included. The study population was divided into ‘non‐alcohol’ (BAC equal to 0‰), ‘legal’ (BAC greater than 0 up to 0.8‰) and ‘illegal’ (BAC greater than 0.8‰) subgroups. Outcome measures included survival, NASCIS motor and sensory scores, NASCIS pain scores and Functional Independence Measure (FIM) determinants at baseline and at 6 weeks, 6 months and 1 year post‐SCI. Analyses were adjusted for major potential confounders: age, sex, ethnicity, trial protocol, Glasgow coma score, and cause, level and severity of SCI. Results Among 499 patients (423 males and 76 females; ages from 14 to 92 years), the mean BAC was 0.054 ± 0.006‰ (range 0–1). The survival at 1 year (94.4%) was not associated with the BAC (P = 0.374). Moreover, BAC was not significantly correlated with motor recovery (P > 0.166), sensory recovery (P > 0.323), change in pain score (P > 0.312) or functional recovery (P > 0.133) at 6 weeks, 6 months and 1 year post‐SCI. Conclusions Our results, for the first time, show that the BAC at emergency admission does not adversely affect the patients' mortality, neurological impairment or functional disability over the course of the first year after SCI.