Pedestrian injuries: the association of alcohol consumption with the type and severity of injuries and outcomes.

BACKGROUND

Literature on the effect of alcohol ingestion on short-term outcomes for trauma patients shows conflicting results. We performed this study to investigate the prevalence of positive alcohol screens and the effect of alcohol level on injury patterns, injury severity, and outcomes in pedestrians and bicyclists involved in a collision with an automobile.

STUDY

DESIGN

The study population included all pedestrians and bicyclists older than 10 years, treated in any of the 13 trauma centers in the Los Angeles County Emergency Services System during the calendar year 2003, who were involved in a collision with an automobile and had a blood alcohol level measured. The alcohol negative group was defined as those patients with a blood alcohol level </=0.05 g/dL. Low and high alcohol groups were defined as those having blood alcohol levels>0.05 g/dL to<0.08 g/dL and>/=0.08 g/dL, respectively. We compared the three study groups with respect to demographics, injury patterns, injury severity, complications, and outcomes. Logistic regression was used to determine if alcohol had an independent association with any outcomes.

RESULTS

There were 1,042 patients who met study criteria. Overall, 606 patients (58%) had a negative alcohol screen, 84 (8%) had low alcohol levels, and 352 (34%) had high alcohol levels. Alcohol level was not notably associated with severity of injury, admission hypotension, ICU length of stay, major complications, and injury pattern (head, chest, abdomen, or extremity Area Injury Score). Mortality was similar in the three alcohol level groups, but the overall complication rate and hospital length of stay were markedly higher in the high alcohol level group than they were in the negative alcohol level group.

CONCLUSIONS

In pedestrians and bicyclists involved in a collision with an automobile, a high alcohol level is not associated with body area severity of injury, overall severity of injury, and hospital mortality. But high alcohol level is notably associated with higher overall complication rate and longer hospital length of stay.