Maio R F, Waller P F, Blow F C, Hill E M, Singer K M
University of Michigan, Department of Surgery, Ann Arbor, USA.
Acad Emerg Med. 1997 Apr;4(4):256-62. doi: 10.1111/j.1553-2712.1997.tb03545.x.
This was a prospective cohort study using a stratified random sample of MVC patients aged > or = 18 years presenting to a university hospital and university-affiliated community hospital ED from May 1, 1992, to August 30, 1994. A diagnosis of current AA/AD was based on the alcohol section of the Diagnostic Interview Survey (DIS). Other measurements included the presence of blood alcohol (BAC+), Injury Severity Score (ISS-85), occupant status (driver/passenger), age, gender, seat belt use, culpability for crash, and ED disposition (admitted vs released). A weighted prevalence was determined; subgroups were compared using t-tests, chi 2, 2-factor analysis, and logistic regression modeling; alpha = 0.05.
1,161 patients were studied. The weighted prevalence of current AA/AD was 22.5%; 53% of these patients were released from the ED. Almost 45% of the patients with current AA/AD were BAC-. When controlling for BAC and AA/AD, greater injury severity and culpability were associated with a BAC+, but not with current AA/AD.
Almost 23% of ED MVC patients have current AA/AD; BAC testing does not accurately identify these patients. Intervention strategies must be directed to both admitted and released patients.
1）确定急诊机动车碰撞（MVC）患者全损伤范围内当前酒精滥用/酒精依赖（AA/AD）的患病率；2）比较AA/AD患者与非AA/AD患者的特征。
这是一项前瞻性队列研究，采用分层随机抽样，选取1992年5月1日至1994年8月30日到一所大学医院和大学附属社区医院急诊科就诊的年龄≥18岁的MVC患者。当前AA/AD的诊断基于诊断性访谈调查（DIS）中的酒精部分。其他测量指标包括血液酒精含量（BAC+）、损伤严重程度评分（ISS-85）、乘客状态（司机/乘客）、年龄、性别、安全带使用情况、事故责任以及急诊处置情况（入院与出院）。确定加权患病率；使用t检验、卡方检验、双因素分析和逻辑回归模型对亚组进行比较；α = 0.05。
共研究了1161例患者。当前AA/AD的加权患病率为22.5%；其中53%的患者从急诊科出院。当前AA/AD患者中近45%的血液酒精含量为阴性。在控制血液酒精含量和AA/AD后，更高的损伤严重程度和事故责任与血液酒精含量阳性相关，但与当前AA/AD无关。
近23%的急诊MVC患者存在当前AA/AD；血液酒精含量检测不能准确识别这些患者。干预策略必须针对入院和出院患者。
