TY  - JOUR
PY  - 2023//
TI  - Substance use and pre-hospital crash injury severity among U.S. older adults: a five-year national cross-sectional study
JO  - PLoS one
A1  - Adeyemi, Oluwaseun
A1  - Bukur, Marko
A1  - Berry, Cherisse
A1  - DiMaggio, Charles
A1  - Grudzen, Corita R.
A1  - Konda, Sanjit
A1  - Adenikinju, Abidemi
A1  - Cuthel, Allison
A1  - Bouillon-Minois, Jean-Baptiste
A1  - Akinsola, Omotola
A1  - Moore, Alison
A1  - McCormack, Ryan
A1  - Chodosh, Joshua
SP  - e0293138
EP  - e0293138
VL  - 18
IS  - 10
N2  - BACKGROUND: Alcohol and drug use (substance use) is a risk factor for crash involvement. <br><br>OBJECTIVES: To assess the association between substance use and crash injury severity among older adults and how the relationship differs by rurality/urbanicity. <br><br>METHODS: We pooled 2017-2021 cross-sectional data from the United States National Emergency Medical Service (EMS) Information System. We measured injury severity (low acuity, emergent, critical, and fatal) predicted by substance use, defined as self-reported or officer-reported alcohol and/or drug use. We controlled for age, sex, race/ethnicity, road user type, anatomical injured region, roadway crash, rurality/urbanicity, time of the day, and EMS response time. We performed a partial proportional ordinal logistic regression and reported the odds of worse injury outcomes (emergent, critical, and fatal injuries) compared to low acuity injuries, and the predicted probabilities by rurality/urbanicity. <br><br>RESULTS: Our sample consisted of 252,790 older adults (65 years and older) road users. Approximately 67%, 25%, 6%, and 1% sustained low acuity, emergent, critical, and fatal injuries, respectively. Substance use was reported in approximately 3% of the population, and this proportion did not significantly differ by rurality/urbanicity. After controlling for patient, crash, and injury characteristics, substance use was associated with 36% increased odds of worse injury severity. Compared to urban areas, the predicted probabilities of emergent, critical, and fatal injuries were higher in rural and suburban areas. <br><br>CONCLUSION: Substance use is associated with worse older adult crash injury severity and the injury severity is higher in rural and suburban areas compared to urban areas.<p />  <p>Language: en</p>
LA  - en
SN  - 1932-6203
UR  - http://dx.doi.org/10.1371/journal.pone.0293138
ID  - ref1
ER  -