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Monday, December 5, 2011

Alcohol and Pedestrians

We all know that it is not safe to drink and drive.  It isn't safe to walk home from the bar either.

Journal of Trauma-Injury Infection & Critical Care:
November 2011 - Volume 71 - Issue 5 - pp 1252-1257
       

Alcohol Use by Pedestrians Who Are Struck by Motor Vehicles: How Drinking Influences Behaviors, Medical Management, and Outcomes

Dultz, Linda A. MD, MPH; Frangos, Spiros MD, MPH; Foltin, George MD; Marr, Mollie BFA; Simon, Ronald MD; Bholat, Omar MD; Levine, Deborah A. MD; Slaughter-Larkem, Dekeya BSc; Jacko, Sally RN, MPH; Ayoung-Chee, Patricia MD; Pachter, H. Leon MD

 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.

Conclusion: 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.

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