Fabbri et al identified risk factors associated with a person having a recurrent motor vehicle accident. This can help identify a person at risk for a future accident who may benefit from preventive measures. The authors are from the Azienda Unita Sanitaria Locale di Forli and Universita di Bologna in Italy.
Patient selection: involvement in a motor vehicle accident with treatment at an Emergency Department. This included drivers, passengers, pedestrians, bicyclists and motorcyclists.
Interval for accident recurrence: 5 years
Parameters
(1) age
(2) gender
(3) blood alcohol concentration at the time of the accident (estimated, which assumes a decline of 20 mg/dL per hour)
(4) time of accident
estimated blood alcohol concentration at the time of the accident in mg/dL =
= (measured blood alcohol on admission in mg/dL) + (20 * (hours since accident))
Parameter |
Finding |
Points |
age of the patient in years |
> 32 years of age |
0 |
|
<= 32 years of age |
1 |
gender of the patient |
female |
0 |
|
male |
1 |
estimated blood alcohol level at the time of the accident |
negative |
0 |
|
positive (>= 50 mg/dL) |
2 |
time of accident |
daytime |
0 |
|
night |
1 |
where:
• The relative risk for alcohol intoxication was 2-3 times that of the other risk factors. The cumulative risk for an alcohol negative subject was around 10% at 5 years vs 45% if alcohol positive.
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The more risk factors the higher the risk of being involved in a future motor vehicle accident.
Another factor that was associated with recurrent injury was the presence of a "dangerous mechanism of injury" which involved one or more of the following:
(1) injured person was the driver
(2) injured person ejected
(3) vehicle out of lane
(4) vehicle overtaking (implies higher speed)
(5) vehicle hit a fixed, nonmoving obstacle
Limitations:
• Some accidents may go unreported or may not be serious enough to warrant emergency care.
• This could be expanded by asking about a person's past history for motor vehicle accidents.
Specialty: Emergency Medicine, Critical Care
ICD-10: ,