Road traffic accident in ivory coast: do alcohol and psychoactive drugs influence pattern and severity of injuries?

Aïssata DIAKITE., Blandine GADEGBEKU., Amina NDAYE., Colette EYA-MINTSA., Sebastien D. DANO., AngladeKla MALAN ., Kla MALAN and Bernard LAUMON

Objective: Although it is well established that alcohol increase the risk of being involved or dying in a Road Traffic Accident (RTA), whether alcohol increase the severity of injuries remains controversial. This could be attributed to differences in inclusion criteria and failure to take into account relevant confounding factors including substances use. The main purpose of our study was to assess the impact of Blood Alcohol Concentration (BAC) on the risk of being seriously injured, after controlling for casualties’ characteristics, substances use and RTA circumstances. Method: 891casualties (32% female) involved in a fatal or non-fatal RTA were enrolled at hospital or Forensic Institute in Ivory Coast. Blood alcohol dosage and urine drug screening were systematically performed, and linked with medical and police data. Injuries severity was coded using the New Injury Severity Score (NISS). We used multivariate logistic regression to model the risk of serious injury in relation to BAC. Results: Our study did not demonstrate any dose-response relationship between alcohol and the severity of injuries. Findings suggest that for surviving casualties attending the emergency room following a RTA, heavy drinkers (BAC > 0.08 %) are not necessarily more severely injured (odd ratio [OR] = 0.9, p > 0.05) compared to moderate drinkers (BAC ≤ 0.08%, OR = 7.7, p < 0.001). Conclusion: Among injured casualties who are not immediately killed and are admitted to the hospital, those with moderate BAC are more at risk to suffer severe injuries. Health prevention and road safety policies should target this population.

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