Dultz Linda A, Frangos Spiros, Foltin George, Marr Mollie, Simon Ronald, Bholat Omar, Levine Deborah A, Slaughter-Larkem Dekeya, Jacko Sally, Ayoung-Chee Patricia, Pachter H Leon
Department of Surgery, New York University School of Medicine, Bellevue Hospital Center, New York, New York, USA.
J Trauma. 2011 Nov;71(5):1252-7. doi: 10.1097/TA.0b013e3182327c94.
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.
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.
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.
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.
在大城市中,行人被机动车撞击受伤是一个重大的公共卫生隐患。本研究的目的是调查被机动车撞击的饮酒者的人口统计学特征,并评估酒精对行人过马路方式、医疗处理及预后的影响。
前瞻性收集2008年12月至2010年9月期间所有被机动车撞击后送至一级创伤中心的行人的数据。通过询问患者、现场目击者、急救人员及查阅病历获取变量。
饮酒的行人在有信号灯时走人行横道过马路的可能性较小(22.6% 对64.7%),而更有可能在有信号灯时不走人行横道过马路(22.6% 对12.4%)或在路中过马路(54.8% 对22.8%)。与未饮酒者相比,饮酒与更多的初始计算机断层扫描成像检查相关。与未饮酒者相比,饮酒与更高的损伤严重度评分(8.82对4.85;p<0.001)及住院时间(3.89天对1.82天;p<0.001)相关。饮酒患者的平均格拉斯哥昏迷量表评分较低(13.80对14.76;p<0.001),且与未饮酒者相比,头颈部、面部、胸部、腹部及四肢/骨盆带损伤(基于简略损伤量表)的发生率更高。
饮酒是行人被机动车撞击的一个重要危险因素。这些患者更有可能以不安全的方式过马路并遭受更严重的损伤。交通安全和伤害预防项目必须解决行人不负责任的饮酒问题。