Analysis of Motor-Vehicle Accidents and Blood Alcohol Concentration (BAC)

• Background Of the more than 40 000 Americans killed each year in vehicular crashes, 40% are involved in alcohol-related collisions. Although self-reported alcohol use has become an anchor for alcohol intervention after traffic crashes, clinicians are often skeptical about the truthfulness of self-reporting. • Objective To determine the validity of self-reported alcohol consumption of vehicular occupants hospitalized for a serious, alcohol-related injury. • Methods Non-alcohol–dependent subjects 18 years and older who were injured in motor vehicle crashes were interviewed. The self-reported number of standard drinks, time that drinking commenced, sex, and weight were used to calculate estimated blood alcohol concentration. This value was compared with the blood alcohol concentration measured at admission. • Results Of the 181 subjects, 60% provided sufficient data to calculate the estimated concentration. Seven men with admission concentrations of 10 mg/dL or more denied drinking. Among the 113 subjects with estimated concentrations who acknowledged drinking (excluding the 7 who denied drinking), the mean concentration at admission was 158.67 mg/dL, and mean estimated concentration was 83.81 mg/dL. According to multiple regression analyses, weight and number of drinks accounted for 3% of the variance in alcohol concentration at admission for women (R =0.174, F2,40 = 0.623, P = .54) and for 29% of the variance in men (R=0.543, F2,128 =26.71, P< .001). • Conclusions Most persons who drink before vehicular injury acknowledge drinking. Self-reported data from men generally reflect the overall trend of alcohol consumption but with systematic underreporting. Reports from women are less predictable.

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The Relationship Between Blood Alcohol Concentration and Injury Severity in Patients Admitted to The Hospital Emergency Department After a Motor Vehicle Accident

Eurasian Journal of Emergency Medicine ◽

10.5152/eajem.2016.64936 ◽

2016 ◽

Vol 15 (3) ◽

pp. 121-125

Author(s):

Serkan Dogan ◽

Nurdan Acar ◽

Arif Alper Cevik ◽

Engin Ozakin ◽

Filiz Baloglu Kaya ◽

...

Keyword(s):

Injury Severity ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Hospital Emergency Department ◽

Blood Alcohol ◽

Hospital Emergency ◽

Vehicle Accident ◽

The Relationship

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Does Level of Blood Alcohol Content Affect Clinical Outcomes After Trauma in Older Adult Patients?

The American Surgeon ◽

10.1177/0003134820943555 ◽

2020 ◽

Vol 86 (9) ◽

pp. 1106-1112

Author(s):

Mary K. Bryant ◽

Katherine Reynolds ◽

Connor Brittain ◽

Zachery Patel ◽

Trista D.S. Reid ◽

...

Keyword(s):

Clinical Outcomes ◽

Older Patients ◽

Injury Severity ◽

Motor Vehicle ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Trauma Patients ◽

Blood Alcohol ◽

Matched Cohort ◽

Poor Outcomes

Introduction Preinjury alcohol use and older age have independently been associated with poor outcomes. This study examined whether higher levels of blood alcohol concentration (BAC) correlated with an increased likelihood of poor outcomes in older trauma patients. Methods This was a retrospective cohort study of injured patients ≥65 years with BAC testing presenting to a Level 1 trauma center between 2015 and 2018. Patients were stratified by BAC at 4 thresholds of intoxication: BAC ≧10 mg/dL, BAC ≧80 mg/dL, BAC ≧150 mg/dL, and BAC ≧200 mg/dL. Propensity score matching using inverse probability of treatment weighting was used to estimate outcomes. Logistic and Poisson regression models were performed for each threshold of the BAC level with the matched cohort to assess clinical outcomes. Results Of all older patients (n = 3112), 32.5% (n = 1012) had BAC testing. In the matched cohort of 883 patients (76.7 ± 8.2 years; 48.1% female), 111 (12.5%) had BAC ≧10 mg/dL, 83 (74.8%) had BAC ≧80 mg/dL, 60 (54.1%) had BAC ≧150 mg/dL, and 37 (33.3%) had BAC ≧200 mg/dL. Falls (60.5%) and motor vehicle crashes (28.9%) were the most common mechanisms of injury. Median (IQR) of Injury Severity Score (ISS) was 5 (1-10). The risk of severe injury (ISS ≧15) was similar between alcohol-positive and alcohol-negative patients (9.9% vs 15.0%, P = .151). BAC ≧10 g/dL was not associated with length of stay, intensive care unit admission, or in-hospital complication, nor was any of the other 3 analyzed BAC thresholds. Conclusion Overall, any detectable BAC along and increasing thresholds of BAC was not associated with poor in-hospital outcomes of older patients after trauma. Alcohol screening was low in this population, and intoxication may bias injury assessment, leading to mistriage of older trauma patients.

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