INJURED PEDESTRIANS IN CAPE-TOWN - THE ROLE OF ALCOHOL

Objective, To establish a profile of injured adult pedestrians and att empt to define the role which alcohol plays in this regard. Design. Pr ospective survey of injured pedestrians who presented consecutively ov er 9 weeks to Groote Schuur Hospital. Data on fatally injured pedestri ans were retrospectively collected from the State Mortuary. Setting. H ospital-based study conducted at the trauma unit, Groote Schuur Hospit al. Participants. A total of 321 pedestrians - 196 injured and 35 'dea d on arrival'. Main outcome measures. Sociodemographics, blood alcohol concentration (BAC) and injury severity. Results. Patients were predo minantly male and, on average, 35.6 years old. They were most frequent ly injured at night and over weekends. The BAC was positive in 62.1% o f pedestrians, and the mean BAC was 0.19 g/dl, Most pedestrians had at least one lower limb injury and nearly half had a head injury; howeve r, BAC-positive pedestrians were 2.6 times more likely to have a head injury (P = 0.0009). Furthermore, BAC-positive pedestrians sustained m ore severe injuries, more frequently required admission to the ICU, ha d longer hospital admissions and were more likely to die of their inju ries. The overall case fatality rate was 19.5%. Conclusions. The influ ence of alcohol intoxication among injured adult pedestrians in Cape T own is high, suggesting that alcohol plays a major role in these accid ents. Consequently, there should be some degree of culpability in thos e who cross the road while in an intoxicated state. However, equal att ention should be given to safe and convenient crossing points, good li ghting and education with regard to the wearing of reflective clothing after dark.