title: Association of Traffic Injuries, Substance Use Disorders, and ED Visit Outcomes among Individuals Aged 50+ Years.
abstract: Motor vehicle traffic (MVT) injury is the second most frequent type of injury among older emergency department (ED) patients. We examined the role of substance use disorders (SUD) in ED visit outcomes among older MVT injury patients either as drivers, passengers, or pedestrians.
  
  
  
  Using the 2012 U.S. National Emergency Department Sample, we employed multinomial logistic regression to analyze the association of SUD with ED visit outcomes among 171,145 ED events by MVT injury patients aged 50+. We estimated marginal probabilities of ED outcomes in three age groups (50-64, 65-74, and 75+) by SUD status.
  
  
  
  MVT injuries were 2.31%, 1.46%, and 0.73% of ED visits in the 50-64, 65-74, and 75+ age groups, and SUDs were found in 4.08%, 1.92%, and 0.94% of the MVT-injury visits in these age groups. SUD had small to medium effects on the risk of hospital admission (RRR = 3.39, 95% CI = 3.14-3.66), transfer to a facility or discharge with initiation of home health care (RRR = 3.18, 95% CI = 2.28-4.44), relative to treat-and-release.
  
  
  
  A larger proportion of those with SUD than those without SUD had multiple and more severe injuries that required hospitalization and institutional care. It is important to include MVT injury prevention in the treatment of older substance misusers.
authors.affiliation: a Professor, School of Social Work , University of Texas at Austin , Austin , TX , USA.
authors.forename: Namkee G
authors.initials: NG
authors.lastname: Choi
authors.affiliation: a Professor, School of Social Work , University of Texas at Austin , Austin , TX , USA.
authors.forename: Diana M
authors.initials: DM
authors.lastname: DiNitto
authors.affiliation: b Lecturer, School of Social Work, University of Texas at Austin , Austin , TX , USA.
authors.forename: C Nathan
authors.initials: CN
authors.lastname: Marti
authors.affiliation: c Assistant Professor, Department of Emergency Medicine , Brown University , Providence , RI , USA.
authors.forename: Bryan Y
authors.initials: BY
authors.lastname: Choi
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Emergency department; hospitalization; motor vehicle traffic injury; older adults; substance use disorder