A PROSPECTIVE INVESTIGATION OR THE IMPACT OF ALCOHOL-CONSUMPTION ON HELMET USE, INJURY SEVERITY, MEDICAL RESOURCE UTILIZATION, AND HEALTH-CARE COSTS IN BICYCLE-RELATED TRAUMA

Study Objective: To examine if a relationship exists between bicycle-r elated injuries, consumption of alcohol, helmet use, and medical resou rce utilization.Design: A prospective cohort study with data from emer gency department, operating room, and inpatient records. Setting: Univ ersity-based trauma center in a medium-sized metropolitan area. Type o f Participants: Adult victims (age greater than or equal to 18 years) of bicycle-related injury presenting to the emergency department. A to tal of 350 patients made up the study population. Results: Group 1 con sisted of 29 patients (8.3%) with detectable blood alcohol levels at t he time of the incident. Group 2 (321 patients) had a measured blood a lcohol level of 0 or no clinical indication of alcohol consumption. Gr oup 1 mean Injury Severity Score was 10.3, with six (20.7%) sustaining at least one severe anatomic injury. Group 2 had an Injury Severity S core of 3.3 (p < 0.0001), with only 4.4% (p = 0.0013) sustaining sever e anatomic injury. Mean length of hospitalization for group 1 was 3.5 days, including a mean of 1.4 intensive care unit days. Mean hospitali zation (0.5 days, p < 0.0001) and intensive care unit (0.1 days, p < 0 .0001) were significantly lower in group 2. Mean combined hospital and physician charges were more than six times greater for group 1 ($7,20 6) than group 2 patients ($1170, p < 0.0001). Conclusion: In patients presenting with bicycle-related injuries, prior consumption of alcohol is highly associated with greater injury severity, longer hospitaliza tion, and higher health care costs. This information is useful in the development of injury prevention strategies to decrease incidence and severity of adult bicycle injuries.