Betz Marian E, Carpenter Christopher R, Genco Emma, Carr David B
Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Division of Emergency Medicine, Washington University School of Medicine, St. Louis, MO.
Inj Epidemiol. 2014 Dec 1;1(1). doi: 10.1186/s40621-014-0018-z.
Driving self-restriction is a well-documented among older drivers but might also occur among younger drivers. Little is known about the driving patterns of emergency department (ED) patients, who may be a high-risk population for motor vehicle crashes (MVCs). We sought to compare the driving patterns and MVCs of younger and older adult ED patients in order to inform development of injury prevention interventions in EDs.
We surveyed English-speaking younger adult (age 25-64) and older adult (age ≥65) ED patients, excluding non-drivers and those who were cognitively-impaired or too sick to participate. We compared drivers by age group and used logistic regression with adjustment for driving frequency to examine factors associated with driving self-restriction.
Of those eligible, 82% (n=178) of younger adult and 91% (n=134) of older adult patients participated; approximately half were women. Similar proportions of younger and older adult patients reported driving everyday/almost everyday (80%) but also self-restricting driving in inclimate weather (48%), heavy traffic (27%), in unfamiliar places (21%), when travelling with passengers (1.6%) or when alone (1.3%). Fewer younger adult than older adult patients avoided driving at night (22% versus 49%) or on highways (6.7% versus 26%). In multivariable logistic regression, factors significantly associated self-imposed driving restriction in ≥1 driving situation were female gender (Odds Ratio [OR] 2.40; 95%CI 1.42-4.05) and ever feeling "confused, nervous or uncomfortable" while driving (OR 1.87; 95% CI 1.03-3.39). There was a non-significant trend for differences in proportions between younger adult (11%) and older adult (6.8%) drivers reporting ≥1 MVC as a driver in the past 12 months.
Similar proportions of younger and older adult ED patients self-restrict driving, albeit in different situations, which has implications for behavioral interventions for injury prevention and for education of patients and medical providers.
驾驶自我限制在老年驾驶员中已有充分记录，但在年轻驾驶员中也可能出现。对于急诊科（ED）患者的驾驶模式知之甚少，而这些患者可能是机动车碰撞（MVC）的高危人群。我们试图比较年轻和老年成年ED患者的驾驶模式和MVC情况，以便为急诊科制定伤害预防干预措施提供依据。
我们对讲英语的年轻成年（25 - 64岁）和老年成年（年龄≥65岁）ED患者进行了调查，排除了非驾驶员以及认知障碍或病情过重无法参与的患者。我们按年龄组比较驾驶员，并使用逻辑回归并调整驾驶频率，以检查与驾驶自我限制相关的因素。
在符合条件的患者中，82%（n = 178）的年轻成年患者和91%（n = 134）的老年成年患者参与了调查；约一半为女性。年轻和老年成年患者中报告每天/几乎每天驾驶的比例相似（80%），但在恶劣天气（48%）、交通拥堵（27%）、不熟悉的地方（21%）、与乘客一起旅行时（1.6%）或独自旅行时（1.3%）也会自我限制驾驶。避免在夜间驾驶（22%对49%）或在高速公路上驾驶（6.7%对26%）的年轻成年患者比老年成年患者少。在多变量逻辑回归中，在≥1种驾驶情况下与自我施加的驾驶限制显著相关的因素是女性（优势比[OR] 2.40；95%置信区间1.42 - 4.05）以及在驾驶时曾感到“困惑、紧张或不舒服”（OR 1.87；95%置信区间1.03 - 3.39）。在过去12个月中报告≥1次作为驾驶员发生MVC的年轻成年（11%）和老年成年（6.8%）驾驶员之间的比例差异有不显著的趋势。
年轻和老年成年ED患者自我限制驾驶的比例相似，尽管情况不同，这对伤害预防的行为干预以及患者和医疗提供者的教育具有启示意义。
