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 ab use, evident in a large number of people injured in automobile acciden ts, contribute to repeated injury, and that treatment for alcohol abus e 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 concentrati ons, and they responded to a questionnaire concerning their prior driv ing and medical histories. Results: Contrary to the assumption that mo tor vehicle injuries are isolated episodes, 68% of MVA patients had ex perienced a prior accident, and 43% had been injured in an MVA before the present event. Prior MVAs were associated with having been previou sly arrested for driving while intoxicated (DWI), with illegal drug us e and with prior hospitalization. Of the MVA patients, 37% were intoxi cated (blood alcohol concentration [BAC] greater than or equal to 100 mg/dl). Elevated BAC was associated with having been stopped for drink ing, having a restricted license, having a DWI arrest, using illegal d rugs 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 v ictims, and treatment for alcoholism might reduce vehicular trauma.