M. Srour1, T. Li1, N. K. Dhillon1, K. Patel1, E. Gillettee1, D. R. Margulies1, E. J. Ley1, G. Barmparas1 1Cedars-Sinai Medical Center,Los Angeles, CA, USA
Introduction: The aim of this study was to characterize alcohol intoxication among pedestrians struck by vehicles and examine whether these patients are more likely to be admitted after hours.
Methods: The Los Angeles County TEMIS database was reviewed for all pedestrians struck by a vehicle over a 16-year period starting in 01/2000. Subjects ≥ 18 years old with available time and day of admission were selected. Patients with available blood alcohol concentration (BAC) were further analyzed and those with positive (+) BAC (> 0 gr %) were compared to those with negative (-) BAC. The primary outcome was mortality.
Results: Of 36,358 patients meeting inclusion criteria, 11,963 (33%) were tested for BAC and of those 3,846 (32%) were (+). The proportion of (+) BAC pedestrians was low from the early morning until early evening (between 4% at 6-7 am to 8% at 5-6 pm). However, after 6 pm there was an abrupt increase in this proportion, peaking at 2-3 am (27% among all admitted pedestrians and 69% among pedestrians tested for BAC). This pattern was observed for all days of the week, but was more profound on Saturdays with the respective proportions reaching 30% and 75%. When (+) BAC patients were compared to their (-) counterparts, they were more likely to be admitted with a Glasgow Coma Scale score ≤ 8 (10% vs. 5%, p < 0.01), with a systolic blood pressure (SBP) < 90 mmHg (3% vs. 2%, p < 0.01). Injury severity scores were similar (median 5 vs 5, p=0.66). The overall mortality was 4%, divided equally between the two cohorts. After adjusting for differences, (+) BAL pedestrians were significantly more likely to survive their injuries (AOR: 0.50, p<0.01).
Conclusion: Pedestrians who are struck by vehicles during late hours are commonly intoxicated. These findings could have implications in developing preventative strategies to separate pedestrians from vehicles or to lower vehicle speed limit after hours in high risk areas.
