Prevalence of indications of alcohol and drug use among patients treated for injurious falls by Emergency Medical Services in the USA.

IF 2.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Injury Prevention Pub Date : 2025-01-02 DOI:10.1136/ip-2024-045447
Nicole G Itzkowitz, Kathryn G Burford, Remle P Crowe, Henry E Wang, Alexander X Lo, Andrew G Rundle
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Abstract

Objective: The association between alcohol consumption and increased injuries from falls is well established, but there is a lack of data on the prevalence of substance use by fall type. This study aims to describe the distribution of alcohol and drug involvement in injurious falls.

Methods: Using the 2019 National Emergency Medical Services (EMS) Information System data set, we identified 1 854 909 patients injured from falls requiring an EMS response and determined the fall location (eg, indoors or on street/sidewalk). We analysed data on the EMS clinician's notation of alcohol or drug involvement and Glasgow Coma Scale.

Results: Overall, for 7.4% of injurious falls, there was a notation of substance use: 6.5% for alcohol alone, 0.6% for drugs and 0.3% for alcohol and drugs. 21.2% of falls that occurred on a street or sidewalk had a notation of substance use. Substance use prevalence was highest, at 30.3%, in the age group 21-64 years, for falls occurring on streets and sidewalks, without syncope or heat illness as contributing factors. Reported substance use involvement was more frequent for men compared with women for each location type. Glasgow Coma Scale scores indicative of moderate or severe trauma were more prevalent among falls involving alcohol and/or drugs.

Conclusions: Overall, one in five injurious falls on streets and sidewalks and requiring EMS attention involved substance use, and these numbers likely underestimate the true burden. As cities seek to expand nightlife districts, design strategies to protect pedestrians from falls should be enacted.

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美国紧急医疗服务部门治疗的伤害性跌倒患者中酒精和药物使用指征的流行程度
目的:酒精消费与跌倒伤害增加之间的联系已经确立,但缺乏按跌倒类型划分的物质使用流行率的数据。本研究旨在描述酒精和药物在伤害性跌倒中的分布。方法:利用2019年国家紧急医疗服务(EMS)信息系统数据集,我们确定了1 854 909名因跌倒而受伤的患者需要EMS响应,并确定了跌倒的位置(例如室内或街道/人行道)。我们分析了EMS临床医生对酒精或药物影响的标记和格拉斯哥昏迷量表的数据。结果:总体而言,在7.4%的伤害性跌倒中,有物质使用的标记:仅酒精为6.5%,药物为0.6%,酒精和药物为0.3%。21.2%发生在街道或人行道上的跌倒有使用物质的标记。在21-64岁年龄组中,发生在街道和人行道上的跌倒发生率最高,为30.3%,没有晕厥或中暑作为诱因。在每个地点类型中,报告的物质使用涉及男性比女性更频繁。格拉斯哥昏迷量表评分表明中度或重度创伤在涉及酒精和/或药物的跌倒中更为普遍。结论:总体而言,五分之一的伤害性跌倒在街道和人行道上,需要紧急医疗服务的关注涉及药物使用,这些数字可能低估了真正的负担。随着城市寻求扩大夜生活区,应该制定保护行人不跌倒的设计策略。
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来源期刊
Injury Prevention
Injury Prevention 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.30
自引率
2.70%
发文量
68
审稿时长
6-12 weeks
期刊介绍: Since its inception in 1995, Injury Prevention has been the pre-eminent repository of original research and compelling commentary relevant to this increasingly important field. An international peer reviewed journal, it offers the best in science, policy, and public health practice to reduce the burden of injury in all age groups around the world. The journal publishes original research, opinion, debate and special features on the prevention of unintentional, occupational and intentional (violence-related) injuries. Injury Prevention is online only.
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