scholarly journals Characteristics and conviction rates of injured alcohol-impaired drivers admitted to a tertiary care Canadian Trauma Centre

2007 ◽  
Vol 30 (1) ◽  
pp. 26 ◽  
Author(s):  
Michelle E. Goecke ◽  
Andrew W. Kirkpatrick ◽  
Kevin B. Laupland ◽  
Marija Bicanic ◽  
Christi Findlay
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Alcohol Intoxication ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Trauma Centre ◽  
Motor Vehicle Crash ◽  
Fatal Injury ◽  
Severity Of Injury ◽  
Legal Consequences

Purpose: Alcohol intoxication is an important factor in motor vehicle crash (MVC) related morbidity and mortality. Despite greater societal attention, medical admission after MVC results in avoidance of legal consequences. We sought to determine characteristics of, and consequences to, injured alcohol-impaired drivers (IAIDs). Methods: All injured adults [Injury Severity Score (ISS) >12, age>18] entered in a Trauma Centre registry between April 1 1995 to March 31 2003 were reviewed. Legally intoxicated patients who had been drivers involved in a MVC and who had a blood alcohol content (BAC) ≥80 mg/dl were cross-referenced to municipal and federal databases to identify investigations, charges, and legal outcomes. Results: Of BACs obtained from 1933 (41%) of 4727 patients; 39% (757) were legally intoxicated (BAC ≥80 mg/dl); 185 (24%) were IAIDs. The IAIDs were generally very intoxicated (mean BAC 190 mg/dl); seriously injured (median ISS 22); often in ICU (47%), and had 8% mortality. Charges were laid against 69 (37%) of IAIDs, only 58 (31%) suffered legal consequences; 27 (15%) of impaired driving, and 31 (17%) of other convictions. All IAIDs who caused a fatal injury to another were convicted. A lower severity of injury of the IAIDs, non-fatal injury to another, and occurrence in the more recent years of the study were independently associated with a conviction in multivariable analysis. Conclusion: Despite increasing convictions over time and among most of those charged, the majority of injured drivers escape legal consequences. Increased BAC testing and reporting of this phenomenon could address this.

Higher Blood Alcohol Concentration is Related to Less Severe Injury Amongst Intoxicated Trauma Patients

2020 ◽  
Author(s):  
Nikathan Kumar ◽  
Kartik Prabhakaran ◽  
Matthew K. McIntyre ◽  
David J. Samson ◽  
Rifat Latifi
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Alcohol Intoxication ◽  
Blood Alcohol Concentration ◽  
Alcohol Ingestion ◽  
Trauma Patients ◽  
Blood Alcohol ◽  
Severity Scores ◽  
Severity Of Injury ◽  
Level 1

Abstract Background Previous studies show varied results regarding the protective effects of alcohol intoxication upon injury and mortality in the setting of trauma. Our study aimed to determine the effects of blood alcohol content (BAC) amongst trauma patients with alcohol ingestion, upon injury type and severity, as well as outcomes. Methods This 4-year retrospective study (2013–2017) used an institutional trauma database to capture all Level 1 and 2 trauma patients (≥14 years old) with BAC > 10 mg/dL presenting to the emergency department at a Level 1 trauma center. Demographic variables including mechanism of injury (MOI) were collected. Patients’ BAC was compared to their calculated injury severity scores (ISS) and abbreviated injury scale (AIS) scores. Analysis included linear regression, T-tests and ANOVAs with Tukey’s post-hoc analysis for continuous variables and Fisher’s exact test for binary variables. Multivariate regression analysis was performed to determine independent predictors of injury severity. Results 332 intoxicated patients were identified (mean BAC: 210.2±87.14 mg/dL, range 12.7–460.0; 74.1% male; median age 35; range: 16–90). The median ISS was 6 (range: 1–48). Patients in motor vehicle collisions had lower BACs (186.0±5.59 mg/dL) than those who fell (233.8±10.42 mg/dL, p = 0.0002), were assaulted (230.4±14.04 mg/dL, p = 0.0261), or were pedestrians struck (259.4±14.17 mg/dL, p = 0.004). Overall, patients with higher BAC had lower GCS, lower ISS, and shorter intensive care unit (ICU) length of stay, but no differences in hospital stay, or ventilator days. Conclusions Trauma patients with higher BAC have lower ISS, less severe chest injury, and shorter ICU stays. These findings suggest that higher levels of alcohol ingestion may portend a protective effect in the setting of trauma with respect to severity of injury that does not mitigate the importance of education and injury prevention but warrants further study into the physiology of alcohol and trauma.

scholarly journals Impaired driving charges in injured impaired drivers requiring treatment in an emergency department

CJEM ◽  
2012 ◽  
Vol 14 (05) ◽  
pp. 290-294 ◽  
Author(s):  
Warren Fieldus ◽  
Ed Cain
Keyword(s):  
Emergency Department ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Trauma Centre ◽  
Motor Vehicle Crash ◽  
Impaired Driving ◽  
Legal Limit ◽  
Vehicle Crash ◽  
Police Records ◽  
The Mean

ABSTRACTObjective:To determine the percentage of injured impaired drivers brought to the only trauma centre in Nova Scotia who were charged with impaired driving.Methods:This retrospective observational study identified alcohol impaired drivers involved in a motor vehicle crash (MVC) brought to the emergency department (ED). Patients were selected based on blood alcohol concentrations (BACs) found to be above the legal limit. Medical records were examined to determine if the patient was the driver in an MVC. Patient records were then cross-referenced with a police database to determine the percentage of injured impaired drivers who were charged with impaired driving.Results:Between April 1, 2006, and April 1, 2008, 1,102 patients brought to the QEII Health Sciences Centre (QEII HSC) ED were found to have BACs over the legal limit. Of these patients, only 57 (5.2%) were found to have been the driver in an MVC. The majority of patients were male (49; 86%), with an average age of 32 years. Most injuries (51; 89.5%) were the result of a single-vehicle crash. The mean Glasgow Coma Scale score was 12.6, and the mean Injury Severity Score was 14.4. Cross-referencing with police records showed that only 22.8% (13 of 57) of injured drivers were charged with impaired driving. Those drivers not charged with impaired driving had a significantly lower median BAC and median age.Conclusion:During the study, the majority of alcoholimpaired drivers injured in an MVC who were brought to the QEII HSC ED for assessment of their injuries were not charged with impaired driving.

scholarly journals Increase in Motor Vehicle Crash Severity: An Unforeseen Consequence of COVID-19

2021 ◽  
pp. 000313482110474
Author(s):  
Elinore J. Kaufman ◽  
Daniel Holena ◽  
George Koenig ◽  
Niels D. Martin ◽  
George O. Maish ◽  
...  
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Motor Vehicle Crash ◽  
Trauma Patients ◽  
Crash Severity ◽  
Population Mobility ◽  
Severity Of Injury ◽  
The Impact ◽  
Allocation Decisions ◽  
At Home

Introduction The 2019 coronavirus (COVID-19) pandemic led to stay-at-home (SAH) orders in Pennsylvania targeted at reducing viral transmission. Limitations in population mobility under SAH have been associated with decreased motor vehicle collisions (MVC) and related injuries, but the impact of these measures on severity of injury remains unknown. The goal of this study is to measure the incidence, severity, and outcomes of MVC-related injuries associated with SAH in Pennsylvania. Materials & Methods We conducted a retrospective geospatial analysis of MVCs during the early COVID-19 pandemic using a state-wide trauma registry. We compared characteristics of patients with MVC-related injuries admitted to Pennsylvania trauma centers during SAH measures (March 21-July 31, 2020) with those from the corresponding periods in 2018 and 2019. We also compared incidence of MVCs for each zip code tabulation area (ZCTA) in Pennsylvania for the same time periods using geospatial mapping. Results Of 15,550 trauma patients treated during the SAH measures, 3486 (22.4%) resulted from MVCs. Compared to preceding years, MVC incidence decreased 10% under SAH measures with no change in mortality rate. However, in ZCTA where MVC incidence decreased, there was a 16% increase in MVC injury severity. Conclusions Stay-at-home orders issued in response to the COVID-19 pandemic in Pennsylvania were associated with significant changes in MVC incidence and severity. Identifying such changes may inform resource allocation decisions during future pandemics or SAH events.

scholarly journals Psychological distress following a motor vehicle crash: evidence from a statewide retrospective study examining settlement times and costs of compensation claims

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017515 ◽  
Author(s):  
Rebecca Guest ◽  
Yvonne Tran ◽  
Bamini Gopinath ◽  
Ian D Cameron ◽  
Ashley Craig
Keyword(s):  
At Risk ◽  
Psychological Distress ◽  
Retrospective Study ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Multivariate Logistic Regression Analysis ◽  
Musculoskeletal Injury ◽  
Motor Vehicle Crash ◽  
Insurance Companies ◽  
Vehicle Crash

ObjectiveTo determine whether psychological distress associated with musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, impacts compensation outcomes such as claim settlement times and costs. Second, to identify factors routinely collected by insurance companies that contribute to psychological distress during the compensation process.DesignStatewide retrospective study.Data sourceAnalysis of the New South Wales statewide (Australia) injury register for MVC survivors who lodged a compensation claim from 2011 to 2013.Participants6341 adults who sustained a musculoskeletal injury and who settled a claim for injury after an MVC. Participants included those diagnosed with psychological distress (n=607) versus those not (n=5734).Main outcome measuresTime to settlement and total costs of claims, as well as socio-demographic and injury characteristics that may contribute to elevated psychological distress, such as socio-economic disadvantage, and injury severity.ResultsPsychological distress in those with a musculoskeletal injury was associated with significantly longer settlement times (an additional 17 weeks) and considerably higher costs (an additional $A41 575.00 or 4.3 times more expensive). Multivariate logistic regression analysis identified risk factors for psychological distress including being female, social disadvantage, unemployment prior to the claim, not being at fault in the MVC, requiring ambulance transportation and rehabilitation as part of recovery.ConclusionsResults provide compelling evidence that psychological distress has an adverse impact on people with musculoskeletal injury as they progress through compensation. Findings suggest that additional resources should be directed toward claimants who are at risk (eg, the socially disadvantaged or those unemployed prior to the claim), the major aim being to reduce risk of psychological distress, such as post-traumatic stress disorder, and associated risk of increased settlement times and claim costs. Prospective studies are now required that investigate treatment strategies for those at risk of psychological distress associated with an MVC.

scholarly journals Did Amendments to the Ontario Highway Traffic Act in 2009-2010 Affect the Proportion of Alcohol-Related Motor Vehicle Collisions Seen at a Level I Trauma Centre over a 10-year Period?

CJEM ◽  
2016 ◽  
Vol 19 (2) ◽  
pp. 106-111
Author(s):  
Meghan Garnett ◽  
Tanya Charyk Stewart ◽  
Michael R Miller ◽  
Rodrick Lim ◽  
Kristine Van Aarsen ◽  
...  
Keyword(s):  
Injury Severity ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Highway Traffic ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Level I ◽  
Legislative Amendments

AbstractObjectivesTo determine if changes to the Ontario Highway Traffic Act (OHTA) in 2009 and 2010 had an effect on the proportion of alcohol-related motor vehicle collisions (MVCs) presenting to a trauma centre over a 10-year period.MethodsA retrospective review of the trauma registry at a Level I trauma centre in southwestern Ontario was undertaken. The trauma registry is a database of all trauma patients with an injury severity score (ISS) ≥12 and/or who had trauma team activation. Descriptive statistics were calculated. Interrupted time series analyses with ARIMA modeling were performed on quarterly data from 2004-2013.ResultsA total of 377 drivers with a detectable serum ethanol concentration (SEC) were treated at our trauma centre over the 10-year period, representing 21% of all MVCs. The majority (330; 88%) were male. The median age was 31 years, median SEC was 35.3 mmol/L, and median ISS was 21. A total of 29 (7.7%) drinking drivers died from their injuries after arriving to hospital. There was no change in the proportion of drinking drivers after the 2009 amendment, but there was a significant decline in the average SEC of drinking drivers after changes to the law. There was no difference in the proportion of drinking drivers ≤21 years after introduction of the 2010 amendment for young and novice drivers.ConclusionsThere was a significance decline in the average SEC of all drinking drivers after the 2009 OHTA amendment, suggesting that legislative amendments may have an impact on drinking before driving behaviour.

An Injury Severity-, Time Sensitivity-, and Predictability-Based Advanced Automatic Crash Notification Algorithm Improves Motor Vehicle Crash Occupant Triage

2016 ◽  
Vol 222 (6) ◽  
pp. 1211-1219.e6 ◽  
Author(s):  
Joel D. Stitzel ◽  
Ashley A. Weaver ◽  
Jennifer W. Talton ◽  
Ryan T. Barnard ◽  
Samantha L. Schoell ◽  
...  
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Motor Vehicle Crash ◽  
Vehicle Crash ◽  
Time Sensitivity

E-bike and classic bicycle-related traumatic brain injuries presenting to the emergency department

2021 ◽  
pp. emermed-2019-208811
Author(s):  
Anna J M Verbeek ◽  
Janneke de Valk ◽  
Ditmar Schakenraad ◽  
Jan F M Verbeek ◽  
Anna A Kroon
Keyword(s):  
Emergency Department ◽  
Brain Injuries ◽  
Injury Severity ◽  
Surgical Intervention ◽  
Alcohol Intoxication ◽  
Trauma Centre ◽  
Abbreviated Injury Scale ◽  
Independent Risk Factors ◽  
Level 1 ◽  
Main Determinants

BackgroundE-bike usage is increasingly popular and concerns about e-bike-related injuries and safety have risen as more injured e-bikers attend the emergency department (ED). Traumatic brain injury (TBI) is the main cause of severe morbidity and mortality in bicycle-related accidents. This study compares the frequency and severity of TBI after an accident with an e-bike or classic bicycle among patients treated in the ED.MethodsThis was a prospective cohort study of patients with bicycle-related injuries attending the ED of a level 1 trauma centre in the Netherlands between June 2016 and May 2017. The primary outcomes were frequency and severity of TBI (defined by the Abbreviated Injury Scale head score ≥1). Injury Severity Score, surgical intervention, hospitalisation and 30-day mortality were secondary outcomes. Independent risk factors for TBI were identified with multiple logistic regression.ResultsWe included 834 patients, of whom there were 379 e-bike and 455 classic bicycle users. The frequency of TBI was not significantly different between the e-bike and classic bicycle group (respectively, n=56, 15% vs n=73, 16%; p=0.61). After adjusting for age, gender, velocity, anticoagulation use and alcohol intoxication the OR for TBI with an e-bike compared with classic bicycle was 0.90 (95% CI 0.56 to 1.45). Independent of type of bicycle, TBI was more likely if velocity was 26–45 km/hour, OR 8.14 (95% CI 2.36 to 28.08), the patient was highly alcohol intoxicated, OR 7.02 (95% CI 2.88 to 17.08) or used anticoagulants, OR 2.18 (95% CI 1.20 to 3.97). TBI severity was similar in both groups (p=0.65): eight e-bike and seven classic bicycle accident victims had serious TBI.ConclusionThe frequency and severity of TBI among patients treated for bicycle-related injuries at our ED was similar for e-bike and classic bicycle users. Velocity, alcohol intoxication and anticoagulant use were the main determinants of the risk of head injury regardless of type of bicycle used.

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