Relations among chronic medical conditions, medications, and automobile crashes in the elderly: A population-based case-control study
Relations among chronic medical conditions, medications, and automobile crashes in the elderly: A population-based case-control study
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DOI：
10.1093/aje/152.5.424
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发表时间：
2000-09-01
影响因子：
5
通讯作者：
Roseman, JM
中科院分区：
文献类型：
--
作者：
McGwin, G;Sims, RV;Roseman, JM
年龄较大的司机撞车率较高，如果他们撞车，更有可能受伤或死亡。医疗条件和药物被假设为参与碰撞的决定因素。这项以人群为基础的病例对照研究旨在确定与老年驾驶员过失撞车风险相关的医疗条件和药物。1996年，从亚拉巴马公共安全部的驾驶记录中选择了901名65岁及以上的驾驶员：244名有过错的驾驶员参与了撞车事故，182名无过错的驾驶员参与了撞车事故; ACID 475名未参与碰撞的驾驶员被登记，关于人口统计学因素、慢性医学状况、药物、驾驶习惯、视觉功能，并收集认知状态。患有心脏病（比值比（OR）= 1.5，95%置信区间（CI）：1.0，2.2）或中风（OR = 1.9，95% CI：0.9，3.9）的老年驾驶员更有可能参与过失车祸。关节炎也与女性风险增加相关（OR = 1.8，95% CI：1.1，2.9）。使用非甾体类药物（OR = 1.7，95%CI：1.0，2.6）、血管紧张素转换酶抑制剂（OR = 1.6，95%CI：1.0，2.7）和抗凝剂（OR = 2.6，95%CI：1.0，73）与车祸事故中过失参与风险增加相关。使用苯二氮卓类药物（OR = 5.2，95% CI：0.9，30.0）也与风险增加相关。钙通道阻滞剂（OR = 0.5，95% CI：0.2，0.9）和血管扩张剂（OR = 0.3，95% CI：0.1，1.0）与降低的撞车风险相关。确定与撞车风险相关的医疗条件和药物对于提高老年驾驶员的安全性和机动性非常重要。
Older drivers have elevated crash rates and are more likely to be injured or die if they have a crash. Medical conditions and medications have been hypothesized as determinants of crash involvement. This population-based case-control study sought to identify medical conditions and medications associated with risk of at-fault crashes among older drivers. A total of 901 drivers aged 65 years and older were selected in 1996 from Alabama Department of Public Safety driving records: 244 at-fault drivers involved in crashes; 182 not at-fault drivers involved in crashes; acid 475 drivers not involved in crashes were enrolled, information on demographic factors, chronic medical conditions, medications, driving habits, visual function, and cognitive status was collected. Older drivers with heart disease (odds ratio (OR) = 1.5, 95% confidence interval (CI): 1.0, 2.2) or stroke (OR = 1.9, 95% CI: 0.9, 3.9) were more likely to be involved in at-fault automobile crashes. Arthritis was also associated with an increased risk among females (OR = 1.8, 95% CI: 1.1, 2.9). Use of nonsteroidal antiinflammatory drugs (OR = 1.7, 95% CI 1.0, 2.6), angiotensin converting enzyme inhibitors (OR = 1.6, 95 CI: 1.0, 2.7), and anticoagulants (OR = 2.6, 95% CI: 1.0, 73) was associated with an increased risk of at-fault involvement in crashes. Benzodiazepine use (OR = 5.2, 95% CI: 0.9, 30.0) was also associated with an increased risk. Calcium channel blockers (OR = 0.5, 95% CI: 0.2, 0.9) and vasodilators (OR = 0.3, 95% CI: 0.1, 1.0) were associated with a reduced risk of crash involvement. The identification of medical conditions and medications associated with risk of crashes is important for enhancing the safety and mobility of older drivers.