Oda Yuya, Motomura Tomokazu, Matsumoto Hisashi
Shock and Trauma Center Nippon Medical School Chiba Hokusoh Hospital Chiba Japan.
Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan.
Acute Med Surg. 2021 May 1;8(1):e649. doi: 10.1002/ams2.649. eCollection 2021 Jan-Dec.
Although decreased level of consciousness (DLOC) while driving may lead to serious accidents involving drivers and people around them, including passengers and pedestrians, few studies have assessed traffic injuries attributable to preceding DLOC. We aimed to identify factors suggestive of a DLOC preceding traffic injury during initial examination.
This study included 193 drivers who were brought to our facility during the 1-year period from January to December 2018. The drivers were divided into those with and without DLOC for comparison and analysis. Data on age, sex, causes of DLOC, and medical history were retrospectively reviewed from medical records.
Of these 193 drivers, 58 (30.1%) had experienced preceding DLOC. The following factors suggested possible episodes of preceding DLOC: a single-vehicle accident (odds ratio [OR] 3.59; 95% confidence interval [CI] 1.76-7.34; < 0.001) and histories of hypertension (OR 2.64; 95% CI 1.13-6.15; = 0.0248) and psychiatric disorders (OR 3.49; 95% CI 1.08-11.3; = 0.0370). The causes of DLOC were endogenous diseases in 20 drivers (34.3%), dozing off episodes in 19 (32.8%), and acute alcohol intoxication in 11 (19.0%).
Before traffic accidents, 30.1% of drivers experienced DLOC. Single-vehicle accidents and histories of hypertension and psychiatric disorders were factors suggestive of preceding DLOC.
虽然驾驶时意识水平下降(DLOC)可能导致涉及驾驶员及其周围人员(包括乘客和行人)的严重事故,但很少有研究评估先前DLOC导致的交通伤害。我们旨在确定在初次检查时提示交通伤害之前存在DLOC的因素。
本研究纳入了2018年1月至12月这1年期间被送至我院的193名驾驶员。将驾驶员分为有DLOC和无DLOC两组进行比较分析。从病历中回顾性审查年龄、性别、DLOC原因和病史等数据。
在这193名驾驶员中,58名(30.1%)曾经历过先前的DLOC。以下因素提示可能存在先前的DLOC发作:单车事故(优势比[OR] 3.59;95%置信区间[CI] 1.76 - 7.34;P < 0.001)以及高血压病史(OR 2.64;95% CI 1.13 - 6.15;P = 0.0248)和精神疾病史(OR 3.49;95% CI 1.08 - 11.3;P = 0.0370)。DLOC的原因包括20名驾驶员(34.3%)的内源性疾病、19名(32.8%)的打瞌睡发作和11名(19.0%)的急性酒精中毒。
在交通事故发生前,30.1%的驾驶员经历过DLOC。单车事故以及高血压和精神疾病史是提示先前存在DLOC的因素。