Alcohol and Drug Overdoses Alone and In Combination as Risk Factors for Emergency Department Motor Vehicle Crash Patients to be Hospitalized

Objective: To assess whether drivers and passengers admitted to emergency departments (EDs) nationwide for injuries sustained in motor vehicle crashes were more likely to require overnight hospitalizations if their medical records indicated at the time of injury they had overdosed on alcohol or drugs or both. Methods: Medicine records from the Nationwide Emergency Department Sample (NEDS) (2006-2009) were examined. NEDS contains unweighted data from over 950 hospitals, approximately a 20% stratified sample of U.S. hospitals based EDs. Logistic regression calculated odds ratios and 95% confidence intervals for having been admitted overnight if injured drivers or passengers overdosed on alcohol or drugs only or both, adjusting for age, sex, residence location, household income, geographic region, and expected primary payer. Results: Among injured drivers, 7% of 1,540,082 who did not overdose were hospitalized, compared to 32% of 39,321 who overdosed on alcohol [OR 6.3 (5.9, 6.8)], 40% of 9,754 overdosed on drugs [OR 9.9 (9.1, 10.8)], and 57% of 4,568 who overdosed on both alcohol and drugs [OR 19.5 (17.4, 21.8). Among injured passengers, 6% of 787,516 who did not overdose were hospitalized compared to 35% of 9,882 who overdosed on alcohol [OR 7.9 (7.3, 8.6)], 40% of 3,375 on drugs [OR 11.7 (10.9, 13.3)], and 58% of 1,459 who overdosed on both alcohol and drugs [OR 23.4 (19.7, 27.7)]. Conclusions: Alcohol and drug overdoses, particularly in combination, significantly elevate the odds that motor vehicle drivers and passengers admitted to emergency departments nationwide will suffer injuries of greater severity requiring hospital admission.