1. Kayyali, Andrea MSN, RN

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Primary risk factor in recurrent ones.

Italian researchers have reported an important finding regarding alcohol use as a factor in motor vehicle accidents in a recently published study, which revealed that the presence of positive blood-level concentrations of alcohol in patients treated for injuries sustained in such accidents, rather than age, sex, or the time of day of the occurrence, was the most significant predictor of the patients' involvement in recurrent ones.


The prospective study included 2,354 adults, all of whom were enrolled during a one-year period after receiving treatment in an ED for injuries sustained in motor vehicle accidents. Patients with a history of alcohol abuse were excluded. Each subject had the blood alcohol level drawn either at the accident site or upon entering the ED, and subsequently was tracked for approximately five years after the visit, or until another one was necessitated by another motor vehicle accident.


Within the follow-up period, approximately 17% of the patients in the initial sample presented to the ED for treatment after a subsequent motor vehicle accident. According to a multivariate regression analysis, the following four factors were found to be predictive of the occurrence of a subsequent accident: male sex, age of 32 years or less, nighttime incidence, and blood alcohol level of 50 mg/dL or higher. When all four factors were present, the rate of the recurrence of an accident was found to be 145 events per 1,000 subject-years. When an alcohol level of 50 mg/dL or higher was considered independently, the incidence rate was 112 events per 1,000 subject-years, indicating that alcohol use played a role in 75% of all recurring accidents and was the primary predictive variable in their occurrence. The researchers estimated that if none of the four variables were present, the recurrence rate would decline to 11 events per 1,000 subject-years.


The predictive finding should be of interest to providers who treat patients injured in motor vehicle accidents, and the researchers suggest interventions such as alcohol abuse screenings, counseling, and referrals.


Fabbri A, et al. Ann Emerg Med 2005;46(2):161-7.