Abstract
BackgroundDriving self-restriction is well-documented among older drivers but might also occur among younger drivers. Little is known about the driving patterns of emergency department (ED) patients, who may be a high-risk population for motor vehicle crashes (MVCs). We sought to compare the driving patterns and MVCs of younger and older adult ED patients in order to inform development of injury prevention interventions in EDs.MethodsWe surveyed English-speaking younger adult (age 25–64) and older adult (age ≥65) ED patients, excluding non-drivers and those who were cognitively-impaired or too sick to participate. We compared drivers by age group and used logistic regression with adjustment for driving frequency to examine factors associated with driving self-restriction.ResultsOf those eligible, 82% (n = 178) of younger adult and 91% (n = 134) of older adult patients participated; approximately half were women. Similar proportions of younger and older adult patients reported driving everyday/almost everyday (80%) but also self-restricting driving in inclimate weather (48%), heavy traffic (27%), in unfamiliar places (21%), when travelling with passengers (1.6%) or when alone (1.3%). Fewer younger adult than older adult patients avoided driving at night (22% versus 49%) or on highways (6.7% versus 26%). In multivariable logistic regression, factors significantly associated self-imposed driving restriction in ≥1 driving situation were female gender (Odds Ratio [OR] 2.40; 95% CI 1.42-4.05) and ever feeling “confused, nervous or uncomfortable” while driving (OR 1.87; 95% CI 1.03-3.39). There was a non-significant trend for differences in proportions between younger adult (11%) and older adult (6.8%) drivers reporting ≥1 MVC as a driver in the past 12 months.ConclusionsSimilar proportions of younger and older adult ED patients self-restrict driving, albeit in different situations, which has implications for behavioral interventions for injury prevention and for education of patients and medical providers.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-014-0018-z) contains supplementary material, which is available to authorized users.
Highlights
Driving self-restriction is well-documented among older drivers but might occur among younger drivers
Similar proportions of younger (83%, 95% confidence intervals (CIs) 77–88) and older (76%, 95% CI 69–83) patients reported driving everyday or almost everyday (Table 1), among older patients fewer women (68%; 95% CI 56–79) than men (85%; 95% CI 76–94) reported this frequency level
A significantly greater proportion of younger (25%, 95% CI 19–31) than older (11%, 95% CI 5.9-17) drivers reported ≥1 stop as a driver in the past 12 months
Summary
Driving self-restriction is well-documented among older drivers but might occur among younger drivers. Little is known about the driving patterns of emergency department (ED) patients, who may be a high-risk population for motor vehicle crashes (MVCs). Other driver characteristics, including female gender and cognitive or visual deficits, have been associated with self-restricted driving by older adults in other studies (Braitman and McCartt 2008; Braitman and Williams 2011; Gwyther and Holland 2012; Lyman et al 2001; Stutts 1998; West et al 2003), but less is known about younger drivers who self-regulate their driving. Less is known about how driving patterns vary by age in ED patients, who may be a population at higher risk of MVCs and other adverse outcomes because of higher levels of comorbidities (Garcia et al 2010), acute injuries or illness (Garcia et al 2010), and social stressors (Institute of Medicine Committee on the Future of Emergency Care in the United States Health System 2007)
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