Original Contributions
Alcohol intoxication increases morbidity in drivers involved in motor vehicle accidents,☆☆

https://doi.org/10.1053/ajem.2003.50025Get rights and content

Abstract

We prospectively examined the correlation of alcohol intoxication with injury severity, morbidity, and mortality in drivers involved in motor vehicle accidents in a prospective cohort study. The study enrolled 923 injured patients, of whom 421 were legally intoxicated (blood alcohol concentration [BAC] ≥ 50 mg/dL) and 502 were nonintoxicated (BAC < 50 mg/dL). The intoxicated drivers had a significantly higher injury severity score (ISS), lower Glasgow Coma Score, lower systolic blood pressure; higher rate in old age, male sex, greater rate of habitual drinking, greater lack of use of safety gear, and greater accident-related morbidity. After logistic regression analysis, alcohol intoxication was not associated with severe injury (ISS ≥ 9); however, alcohol intoxication analyzed either as a preinjury or postinjury risk factor, was one of the predictors for morbidity. Severe head injury was the only predictor of mortality. In conclusion, although alcohol intoxication is not associated with an increased incidence of severe injury or mortality in drivers involved in motor vehicle crashes, it is one of the significant predictors for morbidity after injury. (Am J Emerg Med 2003;21:91-94. Copyright 2003, Elsevier Science (USA). All rights reserved.)

Section snippets

Methods

Five medical centers were involved in the study. During the study period, patients injured in motor vehicle accidents were included as follows: if they had impaired consciousness or were suspected of having consumed alcohol, or had unimpaired consciousness and consented to a blood alcohol examination. Excluded were those who refused to have a blood alcohol examination or were transferred from other hospitals. Measurement of BAC was done immediately when a patient was enrolled in the study.

Results

In the 1-year study period of 1997, 923 injured drivers were enrolled, consisting of 742 males and 181 females. The patients' ages ranged from 16 to 78 years, with an average of 33.4 ± 0.5 years. Eleven percent of the patients were of old age (over 54 years old). Of the 923 patients, 206 were drivers of automobiles (22.3%) and 717 (77.7%) were motorcyclists. There was no significant discrepancy between automobile drivers and motorcyclists in ISS, GCS score, morbidity, or mortality. Alcohol

Discussion

In our study, most of the drivers, whether intoxicated or non-intoxicated, sustained mild or moderate injuries (ISS < 9, 717 of 923 patients; 77.7%). Intoxicated young motorcyclists were the most frequently seen victims involved in motor-vehicle crashes. The intoxicated drivers were less willing to use safety gear and were more frequently involved in noncollision-type accidents than were nonintoxicated drivers; they were less severely injured when involved in noncollision-type accidents. The

Acknowledgements

The authors would like to thank Wei-Kon Chen, MD, of the China Medical College Hospital; Hsiao-Sheng Chang, MD, of the Tzu-Chi General Hospital; Ying-Chieh Huang, MD, of the Kaohsiung Medical University, Chung-Ho Memorial Hospital; and Hau-Chin Liau, MD, of the Chang Gung Memorial Hospital-LinKou, for their help in the collection of the patient data.

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    Address reprint requests to Hsin-Chin Shih MD, Department of Emergency Medicine, Veterans General Hospital-Taipei, No. 201, Sec. 2, Shih-Pai Rd., Taipei, Taiwan. E-mail: [email protected]

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