A Prospective Investigation of the Impact of Alcohol Consumption on Helmet Use, Injury Severity, Medical Resource Utilization, and Health Care Costs in Bicycle-Related Trauma

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Abstract
To examine if a relationship exists between bicycle-related injuries, consumption of alcohol, helmet use, and medical resource utilization. A prospective cohort study with data from emergency department, operating room, and inpatient records. University-based trauma center in a medium-sized metropolitan area. Adult victims (age > or = 18 years) of bicycle-related injury presenting to the emergency department. A total of 350 patients made up the study population. Group 1 consisted of 29 patients (8.3%) with detectable blood alcohol levels at the time of the incident. Group 2 (321 patients) had a measured blood alcohol level of 0 or no clinical indication of alcohol consumption. Group 1 mean Injury Severity Score was 10.3, with six (20.7%) sustaining at least one severe anatomic injury. Group 2 had an Injury Severity Score of 3.3 (p < 0.0001), with only 4.4% (p = 0.0013) sustaining severe anatomic injury. Mean length of hospitalization for group 1 was 3.5 days, including a mean of 1.4 intensive care unit days. Mean hospitalization (0.5 days, p < 0.0001) and intensive care unit (0.1 days, p < 0.0001) were significantly lower in group 2. Mean combined hospital and physician charges were more than six times greater for group 1 ($7,206) than group 2 patients ($1170, p < 0.0001). In patients presenting with bicycle-related injuries, prior consumption of alcohol is highly associated with greater injury severity, longer hospitalization, and higher health care costs. This information is useful in the development of injury prevention strategies to decrease incidence and severity of adult bicycle injuries.