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Pedestrian Intoxication and Fatal Traffic Accident Injury Patterns

Published online by Cambridge University Press:  28 June 2012

James S. Williams*
Affiliation:
Department of Surgery, Memorial Medical Center, Savannah, Ga.
Jonathan A. Graff
Affiliation:
Department of Surgery, State University of New York at Buffalo, Buffalo, N.Y.
Justin M. Uku
Affiliation:
Department of Pathology, Erie County Medical Examiner's Office, Buffalo, N.Y.
*
Department of Surgical Education, Memorial Medical Center, P.O. Box 23089, Savannah, GA 31403-3089USA

Abstract

Introduction:

Sixteen percent of all motor-vehicle fatalities are pedestrian, and accidents involving pedestrians are associated with the highest morbidity and mortality rates. Classic pedestrian injury patterns have been described. However, it has been suggested that the pattern may differ if the pedestrian is intoxicated. The role of pedestrian intoxication on motor-vehicle accident injury patterns has not been well-delineated.

Hypothesis:

Intoxicated pedestrian traffic victims have an injury pattern that is more serious and more rapidly fatal than is the pattern for nondrinking victims.

Methods:

Autopsies of 223 consecutive pedestrian victims were reviewed and grouped according to the presence of alcohol in the blood: Group I, Negative (n = 165); Group II, Positive (n = 58). Gender, age, anatomic injuries, survival time, time of day, and year also were examined.

Results:

Results indicated that there were more males in Group II (79%) than in Group I (64%); younger victims, younger than 40 years old, in Group II (70%) than in Group I (34%); fewer victims older than 60 years old in Group II (8%) than in Group I (38%). Group II sustained more frequent and more severe injuries—two times the frequency of the cervical spine, liver, upper and lower extremity, pelvic and rib fractures and thoracolumbar spine injuries; three times more aortic injuries; five times more heart injuries. Death occurred within 24 hours in 95% of those in Group II and in 67% of those in Group I. Accidents occurred from 1500h to 2300h in 67% of Group II and in 53% of Group I victims.

Conclusion:

Intoxicated pedestrian accident victims are predominantly young men, struck between 1500h and 0700h; they have an injury pattern that is two to five times more serious than is the pattern for the sober victims.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1995

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Footnotes

*

Presented at the American Trauma Society Annual Meeting, Washington, D.C., 20 May 1988.

References

1. Summary Statistics on Fatal Crashes. United States Department of Transportation, National Highway Traffic Safety Administration, 1986; ch 3, p 4.Google Scholar
2. Spitz, WU: The road traffic victim: Correlation of postmortem findings with roadside evidence. In: Spitz, WU, Fisher, RS (eds), Medicolegal Investigation of Death: Guidelines for the Application of Pathology to Crime Investigation 2nd ed. Springfield, Ill: Charles C Thomas, 1980, ch 15.Google Scholar
3. Brainard, BJ, Slauterbeck, J, Benjamin, JB: Fracture patterns and mechanisms in pedestrian motor-vehicle trauma: The ipsilateral dyad. J Orthrop Trauma 1992;6:279282.CrossRefGoogle ScholarPubMed
4. Waddell, JP, Drucker, WR: Occult injuries in pedestrian accidents. J Trauma 1971;11:844852.CrossRefGoogle ScholarPubMed
5. Garland, DE, Glogovac, SV, Waters, RL: Orthopedic aspects of pedestrian victims of automobile accidents. Orthopedics 1979;2:242244.CrossRefGoogle ScholarPubMed
6. Guyer, B, Talbot, AM, Pless, IB: Pedestrian injuries to children and youth. Pediatr Clin North Am 1985;32:163174.CrossRefGoogle ScholarPubMed
7. Waller, JA: Factors associated with alcohol and responsibility for fatal highway crashes. QJ Studies Alcohol 1972;33:160170.CrossRefGoogle ScholarPubMed
8. Jehle, D, Cottington, E: Effect of alcohol consumption on outcome of pedestrian victims. Ann Emerg Med 1988;17:953956.CrossRefGoogle ScholarPubMed
9. McCarroll, JR, Braunstein, PW, Cooper, W, et al. : Fatal pedestrian automotive accidents. JAMA 1962;180:127133.CrossRefGoogle Scholar
10. Farley, HH: Fracture-Trauma Conference: The fatal triad—skull, pelvis, extremity fractures. Minn Med 1965;905907.Google Scholar
11. Vestrup, JA, Reid, JDS: A profile of urban adult pedestrian trauma. J Trauma 1989;29:741745.CrossRefGoogle ScholarPubMed
12. Atkins, RM, Turner, WH, Duthie, RB, et al. : Injuries to pedestrians in road traffic accidents. BMJ 1988;297:14311434.CrossRefGoogle ScholarPubMed
13. Lapidus, G, Braddock, M, Banco, L, et al. : Child pedestrian injury: A population-based collision and injury severity profile. J Trauma 1991;31:11101115.CrossRefGoogle ScholarPubMed
14. Robertson, LS: Car design and risk of pedestrian deaths. Am J Public Health 1990;80:609610.CrossRefGoogle ScholarPubMed
15. Haddon, W Jr, Valien, P, McCarroll, JR, et al. : A controlled investigation of the characteristics of adult pedestrians fatally injured by motor vehicles in Manhattan. J Chronic Dis 1961;14:655678.CrossRefGoogle ScholarPubMed
16. Aronson, SC, Nakabayashi, K, Siegel, M, et al. : Traffic fatalities in Rhode Island: Part IV. The pedestrian victim. RI Med J 1984;67:485489.Google ScholarPubMed
17. Brainard, BJ, Slauterbeck, J, Benjamin, JB, et al. : Injury profiles in pedestrian motor-vehicle trauma. Ann Emerg Med 1989;18:881883.CrossRefGoogle ScholarPubMed
18. Mueller, BA, Rivara, FP, Bergman, AB: Urban-rural location and the risk of dying in a pedestrian-vehicle collision. J Trauma 1988;28:9194.CrossRefGoogle Scholar
19. Braddock, M, Lapidus, G, Gregorio, D, et al. : Population, income, and ecological correlates of child pedestrian injury. Pediatrics 1991;88:12421247.CrossRefGoogle ScholarPubMed
20. Simpson, HM, Mayhew, DR, Warren, RA: Epidemiology of road accidents involving young adults: Alcohol, drugs, and other factors. Drug Alcohol Depend 1982;10:3563.CrossRefGoogle ScholarPubMed
21. Ward, RE, Flynn, TC, Miller, PW, et al. : Effects of ethanol ingestion on the severity and outcome of trauma. Am J Surg 1982;144:153157.CrossRefGoogle ScholarPubMed
22. Irwin, ST, Paterson, CC, Rutherford, WH: Association between alcohol consumption and adult pedestrians who sustain injuries in road traffic accidents. Brit Med J 1983:286:522.CrossRefGoogle ScholarPubMed
23. Snipes, GE: Accidents in the elderly. Am Fam Physician 1982:26:117122.Google ScholarPubMed
24. Champion, HR, Copes, WS, Buyer, D, et al. : Major trauma in geriatric patients. Am J Public Health 1989;79:12781282.CrossRefGoogle ScholarPubMed
25. Coermann, R, Dotzauer, G, Lange, W, et al. : The effects of the design of the steering assembly and the instrument panel on injuries (especially aortic rupture) sustained by car drivers in head-on collision. J Trauma 1972;12:715724.CrossRefGoogle ScholarPubMed
26. Sturm, JT, Billiar, TR, Dorsey, JS, et al. : Risk factors for survival following surgical treatment of traumatic aortic rupture. Ann Thorac Surg 1985:39:418421.CrossRefGoogle ScholarPubMed
27. Greendyke, RM: Traumatic rupture of aorta—special reference to automobile accidents. JAMA 1966;195:119122.CrossRefGoogle ScholarPubMed
28. Baker, SP, Robertson, LS, O'Neill, B: Fatal pedestrian collisions— driver negligence. Am J Public Health 1974;64:318325.CrossRefGoogle ScholarPubMed
29. Haberman, PW: Alcohol and alcoholism in traffic and other accidental deaths. Am J Drug Alcohol Abuse 1987;13:475484.CrossRefGoogle ScholarPubMed