• Michelle E Goecke, Andrew W Kirkpatrick, Kevin B Laupland, Marija Bicanic, and Christi Findlay.
• Departments of Surgery, University of Calgary, Calgary, Alberta, Canada.
• Clin Invest Med. 2007 Jan 1; 30 (1): 26-32.

PurposeAlcohol intoxication is an important factor in motor vehicle crash (MVC) related morbidity and mortality. Despite greater societal attention, medical admission after MVC results in avoidance of legal consequences. We sought to determine characteristics of, and consequences to, injured alcohol-impaired drivers (IAIDs).MethodsAll injured adults [Injury Severity Score (ISS) >12, age>18] entered in a Trauma Centre registry between April 1 1995 to March 31 2003 were reviewed. Legally intoxicated patients who had been drivers involved in a MVC and who had a blood alcohol content (BAC) > or =80 mg/dl were cross-referenced to municipal and federal databases to identify investigations, charges, and legal outcomes.ResultsOf BACs obtained from 1933 (41%) of 4727 patients; 39% (757) were legally intoxicated (BAC > or =80 mg/dl); 185 (24%) were IAIDs. The IAIDs were generally very intoxicated (mean BAC 190 mg/dl); seriously injured (median ISS 22); often in ICU (47%), and had 8% mortality. Charges were laid against 69 (37%) of IAIDs, only 58 (31%) suffered legal consequences; 27 (15%) of impaired driving, and 31 (17%) of other convictions. All IAIDs who caused a fatal injury to another were convicted. A lower severity of injury of the IAIDs, non-fatal injury to another, and occurrence in the more recent years of the study were independently associated with a conviction in multivariable analysis.ConclusionDespite increasing convictions over time and among most of those charged, the majority of injured drivers escape legal consequences. Increased BAC testing and reporting of this phenomenon could address this.

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