Institute of Public Health, Section of Legal Medicine, Polyclinic Gemelli Foundation, Catholic University of the Sacred Heart, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2017 May;21(9):2008-2014.
Driving under the influence of alcohol or drugs is a risk factor for motor vehicle accidents (MVAs). This issue has become an increasing concern for the governments of many European and North American countries, thereby encouraging the adoption of preventive policies. The aim of this study was to investigate the associations between major clinical outcomes and alcohol or drug abuse among drivers involved in MVAs who were referred to an Italian Emergency Department.
The study population consisted of consecutive injured drivers who were admitted to the Emergency Department following an MVA during a period of one year. The patients' blood alcohol concentrations (BACs) and the presence of the most common drugs of abuse [amphetamine, methamphetamine, methylenedioxymethamphetamine (MDMA), barbiturates, benzodiazepines, benzoylecgonine (cocaine main metabolite), cannabinoids, methadone, and opiates)] were determined and evaluated in association with major clinical outcomes and demographic data.
Overall, 347 injured drivers were enrolled. Of the 347 enrolled patients, 164 (47.3%) had a positive BAC (greater than 5 mg/dL). A subgroup of 107 injured drivers was also screened for drugs of abuse. Thirty-seven of these subjects (34.5%) were positive for at least one drug. A statistically significant association was found between BAC and triage at admission (p<0.01), hospitalization (p<0.01), and lesions of internal organs (p=0.04).
The results of this study show that a significant proportion of injured drivers had detectable levels of BAC and/or illegal drugs. Positive BACs were significantly associated with worse clinical outcomes. These findings suggest that the implementation of methods to prevent alcohol and drug abuse is of paramount importance in the effort to reduce the rates of MVAs and their dramatic consequences.
在酒精或药物的影响下驾驶是机动车事故（MVA）的一个风险因素。这个问题已经引起了许多欧洲和北美国家政府的关注，从而鼓励采取预防政策。本研究旨在调查涉及 MVA 并被送往意大利急诊室的驾驶员中主要临床结果与酒精或药物滥用之间的关联。
研究人群包括在一年期间因 MVA 而被送往急诊室的连续受伤驾驶员。确定并评估了患者的血液酒精浓度（BAC）和最常见的滥用药物[苯丙胺、甲基苯丙胺、亚甲双氧甲基苯丙胺（MDMA）、巴比妥类、苯二氮䓬类、苯甲酰可卡因为（可卡因主要代谢物）、大麻素、美沙酮和鸦片类药物]与主要临床结果和人口统计学数据的关系。
共有 347 名受伤驾驶员入组。在 347 名入组患者中，有 164 名（47.3%）BAC 呈阳性（大于 5 毫克/分升）。还对 107 名受伤驾驶员进行了滥用药物的亚组筛查。这些受试者中有 37 名（34.5%）至少有一种药物呈阳性。BAC 与入院时的分诊（p<0.01）、住院（p<0.01）和内部器官损伤（p=0.04）之间存在统计学显著关联。
本研究结果表明，相当一部分受伤驾驶员的 BAC 和/或非法药物可检测到。阳性 BAC 与更差的临床结果显著相关。这些发现表明，实施预防酒精和药物滥用的方法对于降低 MVA 及其严重后果的发生率至关重要。
