Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Traffic Inj Prev. 2010 Feb;11(1):35-42. doi: 10.1080/15389580903419125.
We determined the rate of, and predictive factors for, subsequent impaired driving activity (IDA) by injured drivers treated in a Canadian tertiary care emergency department (ED) following a motor vehicle crash (MVC).
We retrospectively identified all drivers injured in a MVC who presented to our tertiary care, urban ED (1999-2003) and had their blood alcohol content (BAC) measured. Injured drivers were categorized by BAC: group 1, BAC = 0; group 2, 0 < BAC < or = 17.3 mM (80 mg/dL, legal limit); and group 3, BAC > 17.3 mM. IDA was defined as any of the following: a conviction for impaired driving; a 24-h or 90-day license suspension for impaired driving; involvement in alcohol-related MVC. Time to IDA following the index event between groups was compared with Kaplan-Meier survival analyses. Effects of covariates on time to IDA were analyzed using Cox proportional hazards models.
During the study period, 1489 injured drivers met study criteria: 1171 in group 1, 51 in group 2, and 267 in group 3. During an average follow-up of 52.4 months, 82 (30.7%) group 3 drivers engaged in subsequent IDA, compared with 80 (6.8%) group 1 drivers (p < 0.0001). Youth, male gender, history of previous IDA, and the number of previous IDA events were all associated with a significant increase in subsequent IDA. A history of IDA was the strongest predictor of future IDA in group 1 (440% increase risk) and in group 3 (80% increased risk). The magnitude of BAC elevation above the legal limit was not predictive of future IDA.
A high portion of injured impaired drivers who present to hospital engage in repeat IDA following discharge. Besides impairment at time of hospital visit, the best predictor of future IDA is a history of IDA prior to the index event.
我们确定了在加拿大三级护理急诊部（ED）接受治疗的机动车碰撞（MVC）后受伤的驾驶员中，随后出现受损驾驶活动（IDA）的发生率和预测因素。
我们回顾性地确定了所有在 MVC 中受伤并在我们的三级护理城市 ED（1999-2003 年）就诊且其血液酒精含量（BAC）得到测量的驾驶员。受伤的驾驶员按 BAC 分类：组 1，BAC=0；组 2，0<BAC<或=17.3mM（80mg/dL，法定限制）；组 3，BAC>17.3mM。IDA 被定义为以下任何一种情况：因酒后驾车而被定罪；因酒后驾车而被吊销 24 小时或 90 天驾照；涉及与酒精有关的 MVC。使用 Kaplan-Meier 生存分析比较各组之间从指数事件到 IDA 的时间。使用 Cox 比例风险模型分析协变量对 IDA 时间的影响。
在研究期间，有 1489 名受伤的驾驶员符合研究标准：组 1 为 1171 名，组 2 为 51 名，组 3 为 267 名。在平均 52.4 个月的随访期间，组 3 中有 82 名（30.7%）驾驶员发生了随后的 IDA，而组 1 中有 80 名（6.8%）驾驶员（p<0.0001）。年轻、男性、既往 IDA 史和既往 IDA 事件的数量均与随后发生 IDA 的风险显著增加相关。既往 IDA 史是组 1（风险增加 440%）和组 3（风险增加 80%）发生未来 IDA 的最强预测因素。法定限制以上 BAC 升高的幅度与未来 IDA 无关。
大量因受伤而出现的受损驾驶员在出院后会再次出现 IDA。除了就诊时的损伤程度外，IDA 史是发生未来 IDA 的最佳预测因素。
