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    Sunday, January 26, 2003

    Super Bowl Sunday: According to a letter in the New England Journal of Medicine this week, for the past 27 years, traffic fatalities have gone up in the hours after the game, especially in states with losing teams. The authors looked at traffic fatality data for Super Bowl Sundays from 1975 to 2001:

    We observed a 41 percent relative increase in the average number of fatalities after the telecast (24.5 vs. 17.3, P<0.001). In contrast, we observed no significant difference between Super Bowl Sundays and control Sundays in fatalities before the telecast (68.9 vs. 67.0, P>0.20) and a marginal decrease during the telecast (15.7 vs. 17.7, P=0.036). The increase in fatalities after the telecast was evident for 21 of 27 years and amounted to about seven added deaths on the average Super Bowl Sunday as compared with the average control Sunday.

    The increase in fatalities after the telecast also applied to nonfatal injuries and was generally larger in states with a losing team than neutral states and larger in neutral states than states with a winning team (68 percent vs. 46 percent vs. 6 percent, P=0.003). New York and Colorado had the most losses (five and four, respectively) and showed a 147 percent increase for the nine relevant years (95 percent confidence interval, 1 to 510). California had the most wins (eight) and showed no evidence of an increase (change, –4 percent; 95 percent confidence interval, –24 to 22) during those eight years.

    The increase was larger than that seen on New Year's Eve, but what surprised me was the small number of extra deaths:

    The increase in fatalities after the telecast was evident for 21 of 27 years and amounted to about seven added deaths on the average Super Bowl Sunday as compared with the average control Sunday.

    Even one needless death is a tragedy, of course, but seven extra deaths in a nation of 280 million is hardly a public health hazard.

    Super Bowl Sunday II: I have one patient who will be savoring this day more than anyone else on earth. I saw him last week for a cold and was surprised to see that he hadn't had the blood work done that I ordered last September. He's usually very diligent about that sort of thing. This particular blood work was to monitor for side effects of his medication, and he knows that, so I was especially surprised that he hadn't followed through with it. When I asked him why he hadn't, he said he had expected to be dead by Christmas so he didn't think it mattered. He has an aneurysm in his abdominal aorta which he's decided not to have repaired. Repair would be difficult - it's in an area of a previous graft for vascular disease, and he has severe emphysema to boot. His vascular surgeon told him last fall that he'd probably be dead in a few months.

    We discussed that statment when I saw him in September. I had tried to reassure him. That was just statisitcal guess. No doctor can predict when a patient will die. My advice didn't have the same dramatic impact as the surgeon's, though, and it pretty much fell on deaf ears. Now here it is, a month after his expected demise, and he's joyously surprised to still be here. As he left the office, he turned to me and said, "I thought I'd never get to see a Super Bowl again." Enjoy it, Mr. C.

    posted by Sydney on 1/26/2003 09:39:00 AM 0 comments


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