Alcohol abuse/dependence in motor vehicle crash victims presenting to the emergency department

Acad Emerg Med. 1997 Apr;4(4):256-62. doi: 10.1111/j.1553-2712.1997.tb03545.x.


Objective: 1) To determine the prevalence of current alcohol abuse/alcohol dependence (AA/AD) among the full injury range of ED motor vehicle crash (MVC) patients; and 2) compare AA/AD and non-AA/AD patient characteristics.

Methods: This was a prospective cohort study using a stratified random sample of MVC patients aged > or = 18 years presenting to a university hospital and university-affiliated community 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 Interview Survey (DIS). Other measurements included the presence of blood alcohol (BAC+), Injury Severity Score (ISS-85), occupant status (driver/passenger), age, gender, seat belt use, culpability for crash, and ED disposition (admitted vs released). A weighted prevalence was determined; subgroups were compared using t-tests, chi 2, 2-factor analysis, and logistic regression modeling; alpha = 0.05.

Results: 1,161 patients 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 patients 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 patients have current AA/AD; BAC testing does not accurately identify these patients. Intervention strategies must be directed to both admitted and released patients.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidents, Traffic / statistics & numerical data*
  • Adolescent
  • Adult
  • Aged
  • Alcoholic Intoxication / complications
  • Alcoholic Intoxication / epidemiology*
  • Alcoholism / complications
  • Alcoholism / epidemiology*
  • Analysis of Variance
  • Chi-Square Distribution
  • Cohort Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Ethanol / blood
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Logistic Models
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Trauma Severity Indices
  • Wounds and Injuries / etiology*


  • Ethanol