Choi Namkee G, DiNitto Diana M, Marti C Nathan, Choi Bryan Y
a Professor, School of Social Work , University of Texas at Austin , Austin , TX , USA.
b Lecturer, School of Social Work, University of Texas at Austin , Austin , TX , USA.
J Psychoactive Drugs. 2016 Nov-Dec;48(5):369-376. doi: 10.1080/02791072.2016.1240838. Epub 2016 Oct 17.
Motor vehicle traffic (MVT) injury is the second most frequent type of injury among older emergency department (ED) patients. We examined the role of substance use disorders (SUD) in ED visit outcomes among older MVT injury patients either as drivers, passengers, or pedestrians.
Using the 2012 U.S. National Emergency Department Sample, we employed multinomial logistic regression to analyze the association of SUD with ED visit outcomes among 171,145 ED events by MVT injury patients aged 50+. We estimated marginal probabilities of ED outcomes in three age groups (50-64, 65-74, and 75+) by SUD status.
MVT injuries were 2.31%, 1.46%, and 0.73% of ED visits in the 50-64, 65-74, and 75+ age groups, and SUDs were found in 4.08%, 1.92%, and 0.94% of the MVT-injury visits in these age groups. SUD had small to medium effects on the risk of hospital admission (RRR = 3.39, 95% CI = 3.14-3.66), transfer to a facility or discharge with initiation of home health care (RRR = 3.18, 95% CI = 2.28-4.44), relative to treat-and-release.
A larger proportion of those with SUD than those without SUD had multiple and more severe injuries that required hospitalization and institutional care. It is important to include MVT injury prevention in the treatment of older substance misusers.
机动车交通事故（MVT）伤是老年急诊科（ED）患者中第二常见的损伤类型。我们研究了物质使用障碍（SUD）在老年MVT伤患者（无论是作为司机、乘客还是行人）的急诊就诊结局中的作用。
利用2012年美国国家急诊科样本，我们采用多项逻辑回归分析50岁及以上MVT伤患者的171145次急诊事件中SUD与急诊就诊结局的关联。我们按SUD状态估计了三个年龄组（50 - 64岁、65 - 74岁和75岁及以上）的急诊结局的边际概率。
在50 - 64岁、65 - 74岁和75岁及以上年龄组中，MVT伤分别占急诊就诊的2.31%、1.46%和0.73%，在这些年龄组的MVT伤就诊中，SUD分别占4.08%、1.92%和0.94%。相对于治疗后出院，SUD对住院风险（相对风险比RRR = 3.39，95%置信区间CI = 3.14 - 3.66）、转至其他机构或出院并启动家庭医疗护理（RRR = 3.18，95%置信区间CI = 2.28 - 4.44）有中等到较小的影响。
与无SUD者相比，有SUD者中有更大比例的人有多处且更严重的损伤，需要住院治疗和机构护理。在老年药物滥用者的治疗中纳入MVT伤预防很重要。
