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Journal Article

Citation

Adeyemi OJ, Paul R, Dimaggio CJ, Delmelle EM, Arif AA. Drug Alcohol Depend. 2022; 234: 109386.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2022.109386

PMID

35306398

Abstract

BACKGROUND: Understanding how substance use is associated with severe crash injuries may inform emergency care preparedness.

OBJECTIVES: This study aims to assess the association of substance use and crash injury severity at all times of the day and during rush (6-9 AM; 3-7 PM) and non-rush-hours. Further, this study assesses the probabilities of occurrence of low acuity, emergent, and critical injuries associated with substance use.

METHODS: Crash data were extracted from the 2019 National Emergency Medical Services Information System. The outcome variable was non-fatal crash injury, assessed on an ordinal scale: critical, emergent, low acuity. The predictor variable was the presence of substance use (alcohol or illicit drugs). Age, gender, injured part, revised trauma score, the location of the crash, the road user type, and the geographical region were included as potential confounders. Partially proportional ordinal logistic regression was used to assess the unadjusted and adjusted odds of critical and emergent injuries compared to low acuity injury.

RESULTS: Substance use was associated with approximately two-fold adjusted odds of critical and emergent injuries compared to low acuity injury at all times of the day and during the rush and non-rush hours. Although the proportion of substance use was higher during the non-rush hour period, the interaction effect of rush hour and substance use resulted in higher odds of critical and emergent injuries compared to low acuity injury.

CONCLUSION: Substance use is associated with increased odds of critical and emergent injury severity. Reducing substance use-related crash injuries may reduce adverse crash injuries.

Keywords: Ethanol impaired driving; Drug impaired driving


Language: en

Keywords

Injury severity; Substance use; Emergency medical response; Non-fatal crash injury; Non-proportional ordinal logistic regression; Rush hour

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