共享出行服务的普及与降低与酒精相关的机动车碰撞事故发生率和死亡率的相关性。
Correlation of ride sharing service availability and decreased alcohol-related motor vehicle collision incidence and fatality.
机构信息
From the Department of Surgery (J.F., V.H., J.F., T.R., P.M., A.S., S.M., J.D., R.S.), Tulane University School of Medicine, and Louisiana State University Center Health Sciences Center (P.G.), New Orleans, LA.
出版信息
J Trauma Acute Care Surg. 2020 Sep;89(3):441-447. doi: 10.1097/TA.0000000000002802.
BACKGROUND
Alcohol-related motor vehicle collisions (AR-MVCs) account for ~30% of all US traffic fatalities. Ride-sharing services (RSS) have existed since 2010, but few studies to date have investigated their impact on AR-MVCs. We hypothesized that the availability of RSS would be correlated with a decrease in AR-MVCs at an urban Level I trauma center.
METHODS
A retrospective chart review was conducted of all AR-MVC trauma activations at a Level I trauma center from 2012 to 2018. Additional data were gathered from regional governmental traffic and law enforcement databases, including crash incidence, fatalities, and demographics. Data were compared pre- and post-RSS and analyzed using an unpaired t test with p less than 0.05 considered significant.
RESULTS
There were 1,474 patients in AR-MVCs during the study period. There was a significant decrease in the annual average proportion of MVCs that were AR-MVCs pre- vs. post-RSS (39% vs. 29%, p = 0.02) as well as a decrease in the average annual incidence of fatal AR-MVCs (11.6 vs. 5, p = 0.02). Subset analysis showed a decrease in AR-MVC incidence in 18- to 29-year-olds (12.7% vs. 7.5%; p = 0.03), which was also demonstrated by data from a local law enforcement database. Availability of RSS was also correlated with a decreased proportion of nighttime AR-MVCs (14.7% vs. 7.6%, p = 0.03) and decreased number of driving while intoxicated (1198.0 ± 78.5 vs. 612.8 ± 137.6, p = <0.01).
CONCLUSION
We found that the incidence of both total AR-MVCs and fatal AR-MVCs presenting to our trauma center decreased after the introduction of RSS. Ride-sharing services may play a role in preventing AR-MVCs. Further research is needed to correlate AR-MVC incidence with granular proprietary RSS usage data and to account for any confounding factors. Future studies may identify ways to better utilize RSS availability as a targeted intervention for certain demographic groups to prevent AR-MVCs.
LEVEL OF EVIDENCE
Therapeutic/Care Management, Level IV.
背景
在美国，与酒精相关的机动车碰撞（AR-MVC）约占所有交通死亡人数的 30%。拼车服务（RSS）自 2010 年以来就已经存在，但迄今为止，很少有研究调查其对 AR-MVC 的影响。我们假设 RSS 的可用性与城市一级创伤中心的 AR-MVC 减少有关。
方法
对 2012 年至 2018 年在一级创伤中心进行的所有与酒精相关的 MVC 创伤激活进行了回顾性图表审查。还从区域政府交通和执法数据库中收集了其他数据，包括碰撞发生率、死亡率和人口统计学数据。在 RSS 前后对数据进行了比较，并使用配对 t 检验进行了分析，p 值小于 0.05 被认为具有统计学意义。
结果
在研究期间，有 1474 名患者因 AR-MVC 而就诊。与 RSS 前相比，MVC 中 AR-MVC 的年平均比例有显著下降（39%比 29%，p=0.02），致命性 AR-MVC 的年平均发生率也有所下降（11.6 比 5，p=0.02）。亚组分析显示，18 至 29 岁人群的 AR-MVC 发病率下降（12.7%比 7.5%；p=0.03），当地执法数据库的数据也证明了这一点。RSS 的可用性也与夜间 AR-MVC 比例的降低（14.7%比 7.6%，p=0.03）和醉酒驾驶次数的减少（1198.0±78.5 比 612.8±137.6，p<0.01）有关。
结论
我们发现，我们的创伤中心收治的总 AR-MVC 和致命性 AR-MVC 的发生率在引入 RSS 后均有所下降。拼车服务可能在预防 AR-MVC 方面发挥作用。需要进一步的研究来将 AR-MVC 的发生率与特定 RSS 用法的详细数据相关联，并考虑任何混杂因素。未来的研究可能会确定如何更好地利用 RSS 的可用性作为针对特定人群的目标干预措施，以预防 AR-MVC。
证据水平
治疗/护理管理，IV 级。
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