Alcohol and casualties: a comparison of emergency room and coroner data

Data from a probability sample of casualty patients treated at a county hospital emergency room (ER) during a 1 year period (N = 1124) are compared to data from coroner reports of all fatalities arising from unnatural causes during the same time period in the same county (N = 304). The two samples are compared on: demographic characteristics, causes of casualty (fall, laceration/puncture wound, motor vehicle, fire, ingestion, other cause), place of injury, and alcohol and drug use prior to the event. Alcohol and drug use data were obtained by breathalyzer and self-reports in the ER sample and by toxicology screening of blood upon autopsy in the coroner sample. The coroner sample was significantly more likely to be male, younger and white compared to the ER sample. A significantly larger proportion of the coroner sample was positive for alcohol (43%) compared to those breathalyzed within 6 hr of injury who reported no drinking after the event (11%) and to those who reported drinking within the 6 hr prior to the event (28%) in the ER sample. Among those who were alcohol positive no difference was found between the coroner sample and the ER sample for the proportion of those who were also drug positive (24% in each). Cases in the coroner sample were no more likely to involve violence (17%) than those in the ER sample (20%). Violence-related fatalities were more likely to involve alcohol (47%) than non-fatal injuries (19%), but were no more likely to involve drug use in combination with alcohol (39% vs. 31%, respectively).