使用外傷登錄系統探討血液中酒精濃度與事故傷害的流行病學分析

Epidemiological Analysis of Blood Alcohol Level Associated With Accident Injuries From A Traumatic Registration System

丁麗娟(Li-Chuan Ting)

指導教授 ： 許國堂

中山醫學大學/醫學院/醫學研究所/碩士(2014年)

https://doi.org/10.6834/CSMU.2014.00150

摘要

研究目的：近5年來事故傷害仍一直位居十大死亡原因的第六名，且根據行政院衛生福利部2012年衛生統計，意外事故傷害每十萬人口之死亡數為23.8人。而在台灣酒後駕車的比例仍偏高，不僅增加社會成本，也造成許多家庭的支離破碎。故本研究將探討飲酒與事故傷害的相關性，並分析酒精濃度與造成事故傷害的嚴重性。
研究方法及資料：本研究期間為西元2011年1月到2013年12月間以中部某醫學大學附設醫院因飲酒造成事故傷害入院之病患為對象，利用回顧性研究，探討血液中酒精濃度與事故傷害的相關性，本研究工具採用的外傷登錄系統軟體是由外傷醫學會與衛福部國民健康署合作，於2005年發表台灣外傷醫學會外傷登錄系統軟體。此套軟體於2006年發表第二版。本研究經資料蒐集完成之後，以描述性分析呈現，分析方法以SPSS 18.0 for Windows 7版套裝軟體進行「T檢定」及「卡方檢定」，並評估酒精濃度對事故傷害的影響。
研究結果：本研究共收案610名創傷病患，結果顯示有喝酒男性造成意外事故占79.5% 且平均年齡為48.18歲，外傷嚴重度(ISS)平均為24.62分，受傷部位以頭部合併胸腹部占最多為54.76%，平均住院天數為19.3天，死亡率占25.23%。根據本研究資料顯示因飲酒造成意外事故的病患測出其血液中酒精濃度<50 mg/dl以下高達65.7%，與
許多研究指出酒精濃度高於50 mg/dl時，會降低自主協調技巧能力（如開車）有所差異，故本研究結果發現酒精濃度與事故傷害是有相關性、但與外傷嚴重度(ISS)並無相關。
結論與建議：本研究主要發現，機動車事故傷害中，驗出其血液中酒精濃度<50 mg/dl以男性所佔的比例較高，佔71.73%、年齡以18-64歲居多，佔80.43%，而這個族群正是一個國家重要的發展主力。一旦發生意外事故傷害，不只個人身心受影響，也是整個家庭、社會、國家遭受嚴重傷害。由此可見，如何減低甚至避免酒後駕車是一個非常重要的衛生醫療問題。未來可將這些資料再做進一步分析，提供給國家參考並作為立法的依據，更期望能使我國的酒駕肇事率為「零酒駕肇事率」。

關鍵字

血液酒精濃度 ； 事故傷害 ； 外傷登錄

並列摘要

Objective: In the past five years, injuries have been ranked as the sixth of the ten lending causes of death. According to the Executive Yuan Minis-try of Health and Welfare in 2012 from health statistics, accident mortali-ty rate of injuries are 23.8% per 100,000 population. Taiwan is still high rates of drunk driving, not only increases the social costs, but also results in many families sorrow apart. This study investigated the correlation between alcohol consumption and traffic accidents. Furthermore, the al-cohol concentrations associated with accidents were also analyzed.
Methods and Materials: The period of study was from January 2011 to December 2013. The objects of study were from admissions of accidental injuries caused by drinking patients in a hospital of medical university that located at central Taiwan We used the retrospective study on the blood alcohol concentration and accidents related injuries. The trauma login system software tools used in this study were published in Taiwan Medical Association of traumatic injury login system software in 2005 that was in collaboration with the trauma Medical Bureau of Health Pro-motion, Department of Health. This set of software published the second edition in 2006. After completion of data collection, we used "T Test" and "chi-square test," to analyses the influence of alcohol concentration on accident injury with analytical methods from SPSS 18.0 for Windows version 7 package software.
Results: This study collected data from 610 cases of trauma patients in total. The results showed that drinking-males were accounted for 79.5% of accidents and the average age was 48.18 years of age. The trauma se-verity (ISS) with an average of 24.62 points, and the injury sites were head combined chest and abdominal sites representing up to 54.76%. In addition, the average hospital stay was 19.3 days with mortality account-ed for 25.23%. According to our data, up to 65.7% of accidents caused by drinking patients have their blood alcohol measured with concentration <50 mg/dl or less. Many studies have pointed out that when the alcohol concentration is higher than 50 mg/dl that will differentially reduce the capacity of coordination skills. The results of the study found that the concentration of alcohol is positively correlated with traffic accidents, but concentration of alcohol is not related to the injury severity (ISS).
Conclusion and Suggestion: Our study found that higher proportion of males with their blood alcohol concentration <50 mg/dl, accounting for 71.73% of motor vehicle accident injuries. The age of 18-64 years old accounts for 80.43% of motor vehicle accident injuries as the majority. This population is an important power on the development of a country. Once accident injuries, not only physically and mentally affected indi-viduals, but also the whole family, society, nation were suffered serious injuries. Therefore, how to reduce or avoid drinking and driving is a very important health care issue. Future works will do further analysis of these data and make it available to the national reference and as a basis for leg-islation. The long goal is to make our record of drunk driving accident become "zero drunk driving accident rate".

並列關鍵字

Blood Alcohol Concentration (BAC) ； Accident Injuries ； Trauma Registry

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