Alcohol abuse/dependence in motor vehicle crash victims presenting to the emergency department.
OBJECTIVE
1) To determine the prevalence of current alcohol abuse/alcohol dependence (AA/AD) among the full injury range of ED motor vehicle crash (MVC) patients; and 2) compare AA/AD and non-AA/AD patient characteristics.


METHODS
This was a prospective cohort study using a stratified random sample of MVC patients aged > or = 18 years presenting to a university hospital and university-affiliated community hospital ED from May 1, 1992, to August 30, 1994. A diagnosis of current AA/AD was based on the alcohol section of the Diagnostic Interview Survey (DIS). Other measurements included the presence of blood alcohol (BAC+), Injury Severity Score (ISS-85), occupant status (driver/passenger), age, gender, seat belt use, culpability for crash, and ED disposition (admitted vs released). A weighted prevalence was determined; subgroups were compared using t-tests, chi 2, 2-factor analysis, and logistic regression modeling; alpha = 0.05.


RESULTS
1,161 patients were studied. The weighted prevalence of current AA/AD was 22.5%; 53% of these patients were released from the ED. Almost 45% of the patients with current AA/AD were BAC-. When controlling for BAC and AA/AD, greater injury severity and culpability were associated with a BAC+, but not with current AA/AD.


CONCLUSIONS
Almost 23% of ED MVC patients have current AA/AD; BAC testing does not accurately identify these patients. Intervention strategies must be directed to both admitted and released patients.
Maio
R F
RF
University of Michigan, Department of Surgery, Ann Arbor, USA. ronmaio@umich.edu
Waller
P F
PF
Blow
F C
FC
Hill
E M
EM
Singer
K M
KM
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000150:complications / Q000453:epidemiology*; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D000431:Ethanol / Q000097:blood; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000209:etiology*
D000431:Ethanol