Hangovers and Traffic Injuries: Is Alcohol's Influence Greater Than Expected?

宿醉和交通伤害：酒精的影响是否比预期更大？

• 批准号: 8660251
• 负责人: Gordon Stephen Smith
• 金额: $ 50.08万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8660251
• 关键词: Acute; Admission activity; Alcohol abuse; Alcohol consumption; Alcoholic Intoxication; Alcoholism; Alcohols; Beverages; Biological Assay; Biological Markers; Blood; Blood alcohol level measurement; Cessation of life; Clinical assessments; Critical Care; Cross-Over Studies; Data Analyses; Data Sources; Death Records; Development; Disease; Documentation; Elderly; General Population; Glucuronides; Goals; Heavy Drinking; High Prevalence; Hospitals; Impairment; Individual; Injury; Interview; Intoxication; Lead; Link; Maryland; Medical Examiners; Methods; Monitor; Motor Vehicles; Patient Self-Report; Patients; Pattern; Performance; Pharmaceutical Preparations; Police; Policies; Population Attributable Risks; Positioning Attribute; Prevalence; Prevention; Preventive Intervention; Procedures; Regulation; Reporting; Research; Residual state; Risk; Risk Factors; Role; Safety; Shock; Stratification; Symptoms; Systems Analysis; Technology Assessment; Testing; Time; Transportation; Trauma; Universities; Urine; Variant; Vehicle crash; Work; Workplace; alcohol effect; alcohol involvement; alcohol related problem; alcohol screening; case control; clinical practice; college; diethyl sulfate; drinking; drinking behavior; experience; hangover; hazardous drinking; high risk; improved; injured; injury prevention; innovation; instrument; intervention program; medical schools; new technology; novel; patient population; prevent; programs; research study; screening; sobriety; substance abuse prevention; substance abuse treatment; tool; trafficking; trauma centers

DESCRIPTION (provided by applicant): Hangover symptoms and other residual effects of intoxication (hence-forth called residual effects) may be an important but poorly recognized risk factor in many injuries. The long term goal of this study is to reduce alcohol-related injuries through expanding the understanding of alcohol's role in injury risk to also include residual effects of intoxication. We intend to use this information for preventing further injuries and/or hazardous drinking by including recent intoxication assessments as part of routine screening programs for alcohol problems in critical care. We will identify and quantify the role of residual effects in traffic injuries by assessing biomarkers of recent alcohol consumption in urine among Motor Vehicle Crash (MVC) drivers admitted to the University of Maryland R. Adams Cowley Shock Trauma Center (STC) as well as all driver deaths from the medical examiner for the entire state of Maryland for 4 years. This study is an innovative use of two alcohol consumption biomarkers, ethyl glucuronide (EtG) and ethyl sulfate (EtS) in urine as indicators of residual effects even when blood alcohol is zero. The specific hypotheses behind the proposed research are: 1) impairment from residual effects of intoxication increases the risk of traffic injuries; and 2) the prevalence of residual effects of intoxication is elevated among those injured drivers with a zero BAC who were responsible for causing their crash compared to those determined not responsible. Aim 1 defines the quantitative relationship between biomarkers for residual effects, self-reported recent drinking behavior and alcohol problems, time of last drink, and symptom scores from the validated "Hangover Scale" among drivers able to be interviewed in hospital. Interviews will include information on current drinking patterns, CAGE, and hangover symptoms and linked to biomarker results to cross-validate the EtG/EtS estimates of residual effects. Drinking patterns including the place of last drink will also be conducted. Aim 2 quantifies risk factors for injury associated with residual effects using a case-crossover study among interviewed patients. This case-control variant compares drinking during the day immediately prior to the injury (case period) with drinking on the same day the preceding week (control) and can estimate injury risks associated with residual effects. Testing for other drugs allows stratification of results by presence or absence of drugs causing impairment. Aim 3 identifies the extent to which injured zero BAC drivers with biomarker evidence of residual effects are likely to be responsible for causing their crash, compared with zero-BAC drivers without biomarker evidence. This risk factor study involves linkage with police crash reports. Aim 4 determines the prevalence of elevated biomarkers for recent alcohol consumption among BAC zero MVC admissions and deaths. Aim 5 establishes the contribution of residual effects to all alcohol-involved serious MVC injuries and deaths and seeks to improve estimates of the alcohol-attributable fraction for traffic injuries. This novel use of biomarkers provides an unparalleled opportunity to advance understanding of the expanded role of alcohol in traffic injuries.

描述(由申请人提供)：宿醉症状和其他醉酒残留效应(因此称为残留效应)可能是许多损伤的一个重要但未被认识到的危险因素。这项研究的长期目标是通过扩大对酒精在伤害风险中的作用的理解，将醉酒的残余影响也包括在内，以减少与酒精相关的伤害。我们打算将这些信息用于防止进一步的伤害和/或危险饮酒，方法是将最近的中毒评估作为重症监护中酒精问题常规筛查计划的一部分。我们将通过评估马里兰大学R·亚当斯·考利冲击创伤中心(STC)入院的机动车碰撞(MVC)司机以及整个马里兰州4年来法医的所有司机死亡的尿中近期酒精消费的生物标记物，来识别和量化残余影响在交通伤害中的作用。这项研究创新地使用了两种酒精消费生物标志物，即尿液中的乙基葡萄糖醛酸乙酯(EtG)和硫酸乙酯(ETS)，作为即使血液中没有酒精也能显示残余效应的指标。这项拟议研究背后的具体假设是：1)醉酒后遗症的损害会增加交通伤害的风险；2)在那些BAC为零的受伤司机中，与那些被确定为不应对此负责的司机相比，醉酒后遗症的患病率更高。目的1在能够在医院接受访谈的司机中，定义残留效应、自我报告的最近饮酒行为和酒精问题、最后一次饮酒时间和症状评分的生物标志物之间的定量关系。访谈将包括关于当前饮酒模式、CAGE和宿醉症状的信息，并与生物标记物结果联系起来，以交叉验证EtG/ETS对残余影响的估计。还将进行饮酒模式，包括最后一次饮酒的地点。目的2通过对受访患者进行病例交叉研究，量化与残留效应相关的损伤的危险因素。这种病例对照变种将受伤前一天(病例期)饮酒与前一周同一天饮酒(对照)进行比较，可以估计与后遗症相关的伤害风险。对其他药物的检测可以根据是否存在造成损害的药物来对结果进行分层。AIM 3确定了与没有生物标记证据的零BAC司机相比，有生物标记证据的零BAC司机可能在多大程度上导致了他们的撞车事故。这项风险因素研究涉及到与警方撞车报告的联系。目的4确定BAC、零MVC入院和死亡中近期饮酒生物标志物升高的流行率。目标5确定了残留效应对所有涉及酒精的严重MVC伤害和死亡的贡献，并试图改进对交通伤害中酒精可归因性比例的估计。生物标记物的这种新的使用提供了一个无与伦比的机会，以促进对酒精在交通伤害中扩大作用的理解。

项目成果

Prescription medication usage and crash culpability in a population of injured drivers.

受伤司机群体中的处方药使用和车祸责任。

• 发表时间: 2011
• 期刊: Annals of advances in automotive medicine. Association for the Advancement of Automotive Medicine. Annual Scientific Conference
• 作者: Dischinger,Patricia;Li,Jingyi;Smith,GordonS;Ho,Shiu;Auman,Kimberly;Shojai,Dawn
• 通讯作者: Shojai,Dawn

Alcohol and risk of admission to hospital for unintentional cutting or piercing injuries at home: a population-based case-crossover study.

酒精和在家中无意间切割或刺穿伤害医院的风险：一项基于人群的病例分解研究。

• DOI: 10.1186/1471-2458-11-852
• 发表时间: 2011-11-09
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Thornley S;Kool B;Robinson E;Marshall R;Smith GS;Ameratunga S
• 通讯作者: Ameratunga S

Cut-Point Levels of Phosphatidylethanol to Identify Alcohol Misuse in a Mixed Cohort Including Critically Ill Patients.

• DOI: 10.1111/acer.13471
• 发表时间: 2017-10
• 期刊: Alcoholism, clinical and experimental research
• 作者: Afshar M;Burnham EL;Joyce C;Clark BJ;Yong M;Gaydos J;Cooper RS;Smith GS;Kovacs EJ;Lowery EM
• 通讯作者: Lowery EM

Acute respiratory distress syndrome and outcomes after near hanging.

急性呼吸窘迫综合征和接近悬挂后的结果。

• DOI: 10.1016/j.ajem.2014.12.001
• 发表时间: 2015
• 期刊: The American journal of emergency medicine
• 作者: Mansoor,Sahar;Afshar,Majid;Barrett,Matthew;Smith,GordonS;Barr,ErikA;Lissauer,MatthewE;McCurdy,MichaelT;Murthi,SarahB;Netzer,Giora
• 通讯作者: Netzer,Giora

Effectiveness of the YourCall™ text message intervention to reduce harmful drinking in patients discharged from trauma wards: protocol for a randomised controlled trial.

YourCall™ 短信干预对减少创伤病房出院患者有害饮酒的有效性：随机对照试验方案。

• DOI: 10.1186/s12889-016-3967-z
• 发表时间: 2017
• 期刊: BMC public health
• 影响因子: 4.5
• 作者: Ameratunga,Shanthi;Kool,Bridget;Sharpe,Sarah;Reid,Papaarangi;Lee,Arier;Civil,Ian;Smith,Gordon;Thornton,Vanessa;Walker,Matthew;Whittaker,Robyn
• 通讯作者: Whittaker,Robyn