title: Alcohol use by pedestrians who are struck by motor vehicles: how drinking influences behaviors, medical management, and outcomes.
abstract: BACKGROUND
  Injuries to pedestrians struck by motor vehicles represent a significant public health hazard in large cities. The purpose of this study is to investigate the demographics of alcohol users who are struck by motor vehicles and to assess the effects of alcohol on pedestrian crossing patterns, medical management, and outcomes.
  
  
  METHODS
  Data were prospectively collected between December 2008 to September 2010 on all pedestrians who presented to a Level I trauma center after being struck by a motor vehicle. Variables were obtained by interviewing patients, scene witnesses, first responders, and medical records.
  
  
  RESULTS
  Pedestrians who used alcohol were less likely to cross the street in the crosswalk with the signal (22.6% vs. 64.7%) and more likely to cross either in the crosswalk against the signal (22.6% vs. 12.4%) or midblock (54.8% vs. 22.8%). Alcohol use was associated with more initial computed tomography imaging studies compared with no alcohol involvement. Alcohol use was associated with a higher Injury Severity Score (8.82 vs. 4.85; p < 0.001) and hospital length of stay (3.89 days vs. 1.82 days; p < 0.001) compared with those with no alcohol involvement. Patients who used alcohol had a lower average Glasgow Coma Scale score (13.80 vs. 14.76; p < 0.001) and a higher rate of head and neck, face, chest, abdomen, and extremity/pelvic girdle injuries (based on Abbreviated Injury Scale) than those with no alcohol involvement.
  
  
  CONCLUSIONS
  Alcohol use is a significant risk factor for pedestrians who are struck by motor vehicles. These patients are more likely to cross the street in an unsafe manner and sustain more serious injuries. Traffic safety and injury prevention programs must address irresponsible alcohol use by pedestrians.
authors.affiliation: Department of Surgery, New York University School of Medicine, Bellevue Hospital Center, New York, New York, USA.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Dultz
authors.forename: Spiros
authors.initials: S
authors.lastname: Frangos
authors.forename: George
authors.initials: G
authors.lastname: Foltin
authors.forename: Mollie
authors.initials: M
authors.lastname: Marr
authors.forename: Ronald
authors.initials: R
authors.lastname: Simon
authors.forename: Omar
authors.initials: O
authors.lastname: Bholat
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levine
authors.forename: Dekeya
authors.initials: D
authors.lastname: Slaughter-Larkem
authors.forename: Sally
authors.initials: S
authors.lastname: Jacko
authors.forename: Patricia
authors.initials: P
authors.lastname: Ayoung-Chee
authors.forename: H Leon
authors.initials: HL
authors.lastname: Pachter
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D016896:Treatment Outcome; D016138:Walking; D014947:Wounds and Injuries / Q000628:therapy*