Motor vehicle collision fatalities involving alcohol and illicit drugs in Greece: the need for management protocols and a reassessment of surveillance

• Published in: Addiction (Abingdon, England) England), 2010-11, Vol.105 (11), p.1952-1961
• Main Authors: Papadopoulos, Iordanis N., Bonovas, Stefanos, Kanakaris, Nikolaos K., Konstantiadou, Ioanna, Nikolopoulos, Georgios, Konstantoudakis, George, Leukidis, Christos
• Format: Article
• Language: English
• Subjects: Accidents; Accidents, Traffic - mortality; Accidents, Traffic - statistics & numerical data; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Alcohol; Alcohol Drinking - adverse effects; Alcohol Drinking - blood; Alcohol Drinking - epidemiology; Alcohol use; Alcoholic Intoxication - complications; Alcoholic Intoxication - epidemiology; audit; Auditing; Automobile Driving; Autopsy; Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Demographics; Disease management; Drug addiction; Drug use; Drugs; Epidemiology; Female; General aspects; Greece; Greece - epidemiology; Hospitals; Humans; illicit drugs; Law enforcement; Male; Management; Medical sciences; Middle Aged; Mortality; Motor Vehicles; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Substance Abuse Detection - statistics & numerical data; Substance-Related Disorders - blood; Substance-Related Disorders - complications; Substance-Related Disorders - epidemiology; Surveillance; Traffic accidents & safety; Trauma; trauma mortality; Trauma Severity Indices; Wounds and Injuries - blood; Wounds and Injuries - classification; Wounds and Injuries - mortality; Young Adult
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/j.1360-0443.2010.03072.x

ABSTRACT Aims  The frequency and the effect of alcohol and illicit drugs on injury type, severity and location of death in motor vehicle collision (MVC) fatalities were investigated. Design  Retrospective case–control study based on autopsy and toxicology. Settings  Single faculty accepting referrals from Greater Athens and prefectures. Participants  Consecutive pre‐hospital and in hospital fatalities. Measurements  Demographics, toxicology, abbreviated injury scale (AIS), injury severity score (ISS), and location of death. Findings  Of the 1860 screened subjects, 612 (32.9%) constituted the positive toxicology group (PTG) for alcohol or illicit drugs or both and the 1248 (67.1%) the negative toxicology group (NTG). The median age was 34 (4–90) years for the PTG and 45 (3–97) years for the NTG. The PTG included significantly higher proportions of males and motorcyclists. The PTG had a 50% increased risk for a severe (AIS≥3) cervical spine and 85% for a severe upper extremity injury, compared to the NTG. A total of 29.2% of the PTG and 22.4% of the NTG deaths were non‐preventable (ISS = 75). The frequency of severe trauma (ISS≥16) was comparable between PTG and NTG (P = 0.87). The PTG presented with a median ISS of 43 (6–75) versus 41 (2–75) of the NTG, hence without significant difference (P = 0.11). The pre‐hospital death rate was 77.8% for the PTG versus 58% of the NTG (P