Traumatismo craniencefálico grave e moderado em hospital universitário brasileiro: epidemiologia e associação com o uso de cocaína, canabinóides e álcool

Abstract

Aiming at describing the epidemiology of the severe and moderate traumatic brain injury (TBI), and its association with the use of alcohol, cocaine and marijuana, a prospective study was carried out in the city of Uberlândia, from January to December, 2002. Data were collected of 139 victims of severe and moderate TBI aging 18 or more which were admitted in the Emergency Room(ER) of the "Hospital das Clínicas da Universidade Federal de Uberlândia' (Reference trauma hospital in the city). It was observed that 69,3% of the patients came from Uberlândia city and 25% from another cities; the largest admission frequency being on the weekends and during the night period. The largest prevalence belonged to men (85.6%), medium patient age of 40.73 years. The relation mail/female was 5,95/1,00. The medium patient age of 40,7 years, the highest rate was seen at ages 20 and 29 years. About 55,0% of individuals were in leisure activity. About 90,9% was receiving 1-3 minimum salaries each month. The transport accident was the more frequent external cause (64,75%), followed by falling (17,27%) and aggression (16,55%). Among the transport accidents, the largest frequency belonged to motorcyclists (41,58%). The first Pre-Hospital attending was the fireman (41,73%). Among the 139 patients, 56 assisted in a period of 4 months had blood and urine specimen picked up in the admission to the ER, which were used for determination of alcohol, marijuana and cocaine. The alcoholicity prevalence was of 39.3%, and in 75.8% it was superior to 100mg/dl. The largest arrival frequency was in the night period (from 00:00-3:00 hours) and on weekends (Saturday- 66,7% and Friday- 53,8%). There was prevalence of the masculine sex (93,9%). On the cases of aggression 29.4% and 18.2% had positive samples respectively for cocaine and marijuana. Positive exam was not detected in the population above 60 years old. The largest frequency of positive alcoholicity was on aggressions (50.0%). It was present in 60% of the automobile occupants. The prevalence of positive exams for marijuana was of 8.2% and for cocaine of 13.9%, masculine sex. On the cases of aggression 29,4% and 18,2% had positive samples respectively for cocaine and marijuana. Positive exam was not detected in the population above 60 years old. It is observed a larger frequency of TBI and deaths in the most productive age-group as well as a prevalence of transport accidents, facts which account for a huge social cost. The large number of cyclists and motorcyclists that do not wear helmets and also the great percentage of rescues carried out by unskilled professionals as significant data for traffic officers and special aid in the interest of the improvement of prehospital attending in Uberlândia. The large of the use of alcohol, cocaine and marijuana in association with severe and intentional trauma emphasizes the importance of traumatic brain injury as a serious problem of public health and this study may help to the establishment of actions at the aim of reducing these occurrences, before the problem turns out to be even worse.