ALCOHOL ABUSE DEPENDENCE IN MOTOR-VEHICLE CRASH VICTIMS PRESENTING TOTHE EMERGENCY DEPARTMENT/

Objective: 1) To determine the prevalence of current alcohol abuse/alc ohol dependence (AA/AD) among the full injury range of ED motor vehicl e crash (MVC) patients; and 2) compare AA/AD and non-AA/AD patient cha racteristics. Methods: This was a prospective cohort study using a str atified random sample of MVC patients aged greater than or equal to 18 years presenting to a university hospital and university-affiliate co mmunity 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 In terview Survey (DIS). Other measurements included the presence of bloo d alcohol (BAC+), Injury Severity Score (ISS-85), occupant status (dri ver/passenger), age, gender, seat belt use, culpability for crash, and ED disposition (admitted vs released). A weighted prevalence was dete rmined; subgroups were compared using t-tests, chi(2), 2-factor analys is, and logistic regression modeling; alpha = 0.05. Results: 1,161 pat ients 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 p atients 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. Conclusion: Almost 23% of ED MVC patien ts have current AA/AD; BAC testing does not accurately identify these patients. Intervention strategies must be directed to both admitted an d released patients.