ArticleArchives of academic emergency medicine2025
The Impact of Intoxication on the Prognosis of High-Speed Motor Vehicle Accidents: A Tertiary Care Center Experience.
Article in Archives of academic emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Several studies suggest a causal link between psychoactive agents and motor vehicle accidents (MVA). This study aimed to evaluate the impact of substance abuse and alcohol intoxication on the prognosis of high-speed MVA victims. Methods: This is a single-center retrospective cross-sectional study involving adult multiple trauma cases who were admitted to the emergency department for high-speed MVA and underwent toxicological screening. The cohort was conducted based on two main outcomes; the survival status and the neurological outcomes. Results: 894 patients with the mean age of 27.8 ± 9.24 (range:18-37) years were studied (97.9% male). The most common indicators of severity were car rollover and ejection from the car. 296 of the patients had severe traumatic brain injury (TBI). 622 of the patients had a positive toxicological screening, with benzodiazepines (51.2%) and alcohol (26.6%) being the most commonly abused substances. The mortality rate was 5.8% and 12.1% of the patients had unfavorable neurological outcomes upon discharge. On multivariate logistic regression, predictors of mortality among high-speed MVA victims were report of a death at the scene (adjusted odds ratio (aOR): 2.529; 95% confidence interval (CI): 1.026-6.232; p = 0.044), severe TBI, the presence of dilated pupils (aOR: 11.074; 95% CI: 1.293-94.812; p = 0.028), hypotension (aOR: 0.456; 95% CI: 0.227-0.916; p = 0.027), and hypoxia (aOR: 2.95; 95% CI: 1.46-5.95; p = 0.003). Predictors of unfavorable neurological outcomes were report of a death at the scene (aOR: 3.133; 95% CI: 1.445-6.791; p = 0.004), positive toxicology screening (aOR: 3.30; 95% CI:1.68-10.204; p = 0.038), severe TBI, the presence of hypoxia (aOR: 2.96; 95% CI:1.645-5.319; p = 0.000), hypotension (aOR: 0.437; 95% CI: 0.252-0.758; p = 0.003), and bleeding (aOR: 0.287; 95% CI: 0.164-0.501; p < 0.001). Conclusion: A concerning proportion of high-speed MVA victims had a positive toxicology screening. Although intoxication did not increase mortality of high-speed MVAs, it was a significant predictor of unfavorable neurological outcomes of survivors.
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