Elsevier

Annals of Emergency Medicine

Volume 32, Issue 3, September 1998, Pages 349-352
Annals of Emergency Medicine

Injured Intoxicated Drivers: Citation, Conviction, Referral, and Recidivism Rates,☆☆,

Presented in part at the American College of Emergency Physicians Research Forum, Cincinnati, OH, February 1996.
https://doi.org/10.1016/S0196-0644(98)70012-5Get rights and content

Abstract

Study objectives: Several studies have suggested that legally intoxicated drivers who are injured when involved in a motor vehicle crash are unlikely to be cited or prosecuted for driving under the influence (DUI). The purpose of this study was to determine (1) the rates of citation and prosecution of legally intoxicated drivers who are injured in a motor vehicle crash and hospitalized in a Level I trauma center, (2) the rates of previous and subsequent alcohol-related citation in this population, and (3) the rate of referral for treatment of alcohol-related problems made during the hospital stay. Methods: In a retrospective review of trauma registry and Cleveland Municipal Court records from January 1993 through April 1995, we examined the records of all drivers injured in a motor vehicle crash who were transported to a Level I urban trauma center, admitted to the trauma service, and determined to have a blood alcohol content (BAC) of .10 gm% or higher at the time of admission to the emergency department. Results: Seventy drivers admitted after a motor vehicle crash had a BAC of .10 gm% or higher. This represented 33% of the drivers older than 16 years of age who were admitted to the trauma service. Twenty-three drivers (32.8%) were cited for DUI, and 15 (21%) of the 70 were successfully prosecuted and convicted. Four of 23 cited drivers had previous citations; another 5 incurred subsequent citations during the study period. Eight of the 70 drivers who were admitted with a high BAC were referred for outpatient alcohol counseling after discharge. None were offered counseling as inpatients. Conclusion: Citation and prosecution rates of legally intoxicated drivers injured in motor vehicle crashes and hospitalized in our trauma center were low. Recognition of alcoholism and inpatient counseling were rare. Multiple alcohol-related citations were common among drivers cited for DUI. [Cydulka RK, Harmody MR, Barnoski A, Fallon W, Emerman CL: Injured intoxicated drivers: Citation, conviction, referral, and recidivism rates. Ann Emerg Med September 1998;32:349-352.]

Section snippets

INTRODUCTION

Although the dangers of driving under the influence of alcohol (DUI) are well publicized, DUI remains the most frequently cited cause of death on the nation’s highways. 1, 2 Approximately 500,000 people are injured each year in alcohol-related collisions. Traffic accidents are the No. 1 killer of people between the ages of 5 and 34 years, and alcohol is involved in up to 55% of all fatal crashes. 2 As a result, many states have passed stringent laws to combat this problem. In Ohio alone, more

MATERIALS AND METHODS

A retrospective review of the trauma registry at MetroHealth Medical Center was conducted to identify all drivers involved in vehicular accidents within the City of Cleveland who were admitted to the trauma service between January 1993 and April 1995. Drivers were identified by applicable cause of external injury codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. MetroHealth Medical Center is an urban, Level I trauma center. We included only drivers

RESULTS

A total of 211 drivers older than 16 years of age whose crash occurred within the City of Cleveland jurisdiction were admitted to MetroHealth Medical Center’s trauma service between January 1993 and April 1995. Seventy (33%) of these drivers had a BAC of .10 gm% or higher. The BAC of intoxicated drivers ranged from .10 to .42 gm%, with an average (±SD) of .24±.086 gm%. Fifty-one drivers (73%) were men. The mean age of intoxicated drivers was 32±11.8 years.

Twenty-three (32.8%) of the 70 were

DISCUSSION

Several investigators have studied citation and conviction rates for DUI among patients admitted to a trauma service. 3, 4, 5, 6, 7, 8, 9 McLaughlin et al 4 reported a conviction rate of 59% among injured intoxicated drivers, compared with 100% for uninjured intoxicated drivers. Rehm et al 5 found that only 14% of 81 intoxicated injured drivers were convicted of their offense. Colquitt et al 6 reported that 42% of 49 injured intoxicated drivers presenting to a Level I trauma center in Grand

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    From the Departments of Emergency Medicine * and Surgery, ‡ MetroHealth Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH.

    ☆☆

    Reprint no. 47/1/92114

    Address for reprints: Rita K Cydulka, MD Emergency Medicine, S1-203 MetroHealth Medical Center 2500 MetroHealth Drive Cleveland, OH 44109 216-778-5088 Fax 216-778-5349

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