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A Prospective Investigation of the Impact of Alcohol Consumption on Helmet Use, Injury Severity, Medical Resource Utilization, and Health Care Costs in Bicycle-Related Trauma

Spaite, Daniel W. MD, FACEP; Criss, Elizabeth A. RN; Weist, David J. MD; Valenzuela, Terence D. MD, FACEP; Judkins, Daniel RN, MPH; Meislin, Harvey W. MD, FACEP

The Journal of Trauma: Injury, Infection, and Critical Care: February 1995 - Volume 38 - Issue 2 - p 287-290

Study Objective  To examine if a relationship exists between bicycle-related injuries, consumption of alcohol, helmet use, and medical resource utilization.

Design  A prospective cohort study with data from emergency department, operating room, and inpatient records.

Setting  University-based trauma center in a medium-sized metropolitan area.

Type of Participants  Adult victims (age greater than or equal to 18 years) of bicycle-related injury presenting to the emergency department. A total of 350 patients made up the study population.

Results  Group 1 consisted of 29 patients (8.3%) with detectable blood alcohol levels at the time of the incident. Group 2 (321 patients) had a measured blood alcohol level of 0 or no clinical indication of alcohol consumption. Group 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 Score of 3.3 (p < 0.0001), with only 4.4% (p = 0.0013) sustaining severe anatomic injury. Mean length of hospitalization for group 1 was 3.5 days, including a mean of 1.4 intensive care unit days. Mean hospitalization (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 ($7,206) 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 hospitalization, 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.

From the Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, Tucson, Arizona.

This study was funded, in part, by the U.S. Consumer Product Safety Commission.

Presented to the Twenty-third Annual Meeting of the Society for Academic Emergency Medicine, San Francisco, California, May 17-20, 1993.

Address for reprints: Daniel W. Spaite, MD, FACEP, Arizona Emergency Medicine Research Center, University of Arizona College of Medicine, 1501 North Campbell Avenue, Tucson, AZ 85724.

© Williams & Wilkins 1995. All Rights Reserved.