title: Legal prosecution of alcohol-impaired drivers admitted to a level I trauma center in Rhode Island.
abstract: BACKGROUND
  Despite harsh legislation, driving under the influence of alcohol (DUI) is exceedingly common, and alcohol-related motor vehicle crashes (MVCs) account for significant morbidity, mortality, and economic loss. Legal sanctions can keep offenders off the road (protecting other drivers and pedestrians) and ensure compliance with treatment programs (reducing recidivism). However, even with clear evidence of a transgression, the law seems to be inconsistently enforced among trauma patients. The purpose of this study was to measure the rate of legal prosecution among impaired drivers admitted to a trauma center after MVCs, and to determine the recidivism rate among these individuals.
  
  
  METHODS
  Our trauma registry was queried to identify intoxicated drivers admitted during an 18-month period. Court records identified patients who had been charged with traffic offenses, including prior (2 years) and subsequent (1 year) charges.
  
  
  RESULTS
  Blood alcohol concentration (BAC) was measured in 387 (74%) of 525 drivers, of whom 137 (35%) had BAC > or =100 mg/dL. Of 113 state residents, 22 (19%) were charged with an offense related to the MVC. Of 12 charged with DUI, 10 were convicted, for an overall DUI conviction rate of just 9%. Seven (32%) of those who were charged had prior or subsequent charges. Of 91 patients not charged for the index event, 31 (34%) had prior or subsequent charges.
  
  
  CONCLUSIONS
  Alcohol is involved in a large percentage of MVCs in our region. The infrequency of prosecution for DUI despite property damage and/or personal injury, and the high recidivism rate, are significant social concerns. These data suggest the need for processes to facilitate legal prosecution--possibly including revision of legislation involving reporting of BACs.
authors.affiliation: Department of Surgery, Rhode Island Hospital/Brown Medical School, Providence, 02903, USA. walt@biffl.com
authors.forename: Walter L
authors.initials: WL
authors.lastname: Biffl
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Schiffman
authors.forename: David T
authors.initials: DT
authors.lastname: Harrington
authors.forename: John
authors.initials: J
authors.lastname: Sullivan
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Tracy
authors.forename: William G
authors.initials: WG
authors.lastname: Cioffi
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D000328:Adult; D000435:Alcoholic Intoxication / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012042:Registries; D012237:Rhode Island; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States; D014947:Wounds and Injuries / Q000097:blood / Q000209:etiology* / Q000401:mortality