Association between alcohol use and unintentional injuries post-spinal cord injury (SCI)

Purpose: To assess the association between alcohol use and unintentional injury (UI) occurrence post-SCI.

Methods: National survey. Mean UIs in the past year, since SCI, and IU-related hospitalizations were calculated. A zero-inflated negative binomial model was used to examine associations between individual characteristics and drinking behavior with UI. Percent change in expected counts was computed in persons with > 1 UI.

Results: Respondents included 3417 veterans with SCI; analyses included 2874 with complete data. Nearly 20% had > 1 UI in the prior year, 44% of which indicated multiple UIs. Since SCI, 61% had > 1 IU, of which 64% had > 1 IU-related hospitalizations. Nearly 40% consumed > 1 drink in 30 days; the average number of drinks per day was 2.2. Overall, 4% were chronic and 10% binge drinkers. The expected number of UIs increased by 39% for persons with > 1 chronic diseases (IRR=1.39; 95% CI: 1.03-1.87; p=0.031). Persons with paraplegia had an expected UI count 48% higher (IRR=1.48; 95% CI: 1.15-1.89; p=0.002) than those with tetraplegia. Poor physical (IRR= 1.024; 95% CI: 1.010-1.039; p=0.001) and mental (IRR=1.041, 95% CI: 1.029-1.054, p=0.000) health were associated with more UIs during the prior year. As average drinks per day increased, the expected number of UIs increased by 19% (IRR=1.19; 95% CI: 1.10-1.28; p=0.010).

Conclusions: Post-SCI UIs and UI-related hospitalizations were common. UIs can strain the individual and the health system (costly visits). Risk for UIs increased as monthly drinks consumed increased. Strategies to decrease UIs should address drinking behaviors.