Identification of the motor vehicle accident victim who abuses alcohol: an opportunity to reduce trauma.

OBJECTIVE

We hypothesized that a poor driving history and alcohol abuse, evident in a large number of people injured in automobile accidents, contribute to repeated injury, and that treatment for alcohol abuse may reduce vehicular trauma.

METHOD

Patients (N = 150) admitted to the emergency surgical service because of injury sustained in a motor vehicle accident (MVA) were tested for their blood alcohol concentrations, and they responded to a questionnaire concerning their prior driving and medical histories.

RESULTS

Contrary to the assumption that motor vehicle injuries are isolated episodes, 68% of MVA patients had experienced a prior accident, and 43% had been injured in an MVA before the present event. Prior MVAs were associated with having been previously arrested for driving while intoxicated (DWI), with illegal drug use and with prior hospitalization. Of the MVA patients, 37% were intoxicated (blood alcohol concentration [BAC] > or = 100 mg/dl). Elevated BAC was associated with having been stopped for drinking, having a restricted license, having a DWI arrest, using illegal drugs and having a previous admission to a hospital. Prior MVAs, prior DWIs, elevated BAC and male gender formed the Louisville Alcohol Abuse Predictor Checklist and were independent predictors of alcohol abuse diagnosis, based on the patient's self-report of problems with alcohol. Forty-two percent of MVA patients were diagnosed as alcohol abusers. The alcohol abuser had a significantly higher rate of recurrent MVAs, DWIs and injuries than did nonabusers.

CONCLUSIONS

Surgical service may present an opportunity for assessment of alcohol abuse among MVA victims, and treatment for alcoholism might reduce vehicular trauma.