Traumatic pedestrian and bicyclist injuries associated with intoxication

Area of Science:

• Trauma research
• Public health
• Toxicology

Background:

• Drug and alcohol use are established risk factors for motor vehicle operator trauma.
• These substances also contribute significantly to trauma incidence and severity in pedestrians and bicyclists.
• This study investigates the prevalence and clinical outcomes of substance use in injured pedestrians and bicyclists.

Purpose of the Study:

• To determine the prevalence of drug and alcohol use in pedestrians and bicyclists presenting with trauma.
• To describe the clinical consequences and injury patterns associated with substance use in this population.
• To compare outcomes between substance-using and non-substance-using injured pedestrians and bicyclists.

Main Methods:

• Retrospective analysis of trauma team activations over 25 months (January 2017-January 2019).
• Inclusion of 94 pedestrian and bicyclist trauma cases with toxicology screening (blood ethanol, urine drug screens).
• Comparison of outcomes between patients with positive toxicology screens (n=69) and negative screens (n=25), including injury patterns and emergency department disposition.

Main Results:

• Fentanyl, opiates, and tetrahydrocannabinol (THC) were the most frequently detected drugs, with 21 patients testing positive for ethanol.
• Pedestrians comprised 55% of those with positive toxicology screens.
• Substance-involved pedestrians and bicyclists were significantly more likely to sustain fractures, require surgery, or need intensive care unit admission compared to their sober counterparts.

Conclusions:

• Intoxicated pedestrians and bicyclists experience more frequent and severe injuries than sober individuals.
• Findings underscore the heightened risk associated with impaired mobility in traffic environments.
• Public health campaigns are recommended to educate vulnerable road users on the dangers of alcohol and drug use while cycling or walking.