创伤性死亡中的酒精与非法药物：患病率及其与损伤类型和严重程度的关联。

Alcohol and illicit drugs in traumatic deaths: prevalence and association with type and severity of injuries.

作者信息

Demetriades Demetrios, Gkiokas George, Velmahos George C, Brown Carlos, Murray James, Noguchi Thomas

机构信息

Department of Surgery, Division of Trauma and Surgical Intensive Care Unit, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

出版信息

J Am Coll Surg. 2004 Nov;199(5):687-92. doi: 10.1016/j.jamcollsurg.2004.07.017.

DOI:10.1016/j.jamcollsurg.2004.07.017

PMID:15501107

Abstract

BACKGROUND

My colleagues and I studied alcohol and illicit drug intoxication in trauma fatalities and their association with the nature and severity of injuries.

STUDY DESIGN

We examined the trauma registry and autopsies of all trauma fatalities at an academic Level I trauma center. Statistical analysis was performed to evaluate the association of substance use with the Injury Severity Score, body areas with severe trauma (Abbreviated Injury Score >/= 3), and spinal injuries.

RESULTS

From January 2000 to May 2003, 931 trauma deaths occurred; 600 victims were tested for alcohol and illicit drugs and 256 of these (42.7%) tested positive. Male victims were significantly more likely to have a positive screen than female patients (46.1% versus 26.7%, p = 0.0003). Penetrating trauma was significantly more likely to be associated with a positive screen than blunt trauma (53.0% versus 31.0%, p < 0.001). Hispanic and African-American victims were more likely to have a positive screen than Caucasians or Asians. Half the patients in the age group 15 to 50 years had a positive screen. Victims with penetrating trauma and positive screen were significantly more likely to be dead at hospital arrival than victims with negative toxicology (68.8% versus 48.8%, p = 0.05). Pedestrians killed by automobiles who had positive screens were more likely to have severe abdominal trauma (Abbreviated Injury Score >/= 3) than victims with negative toxicology (54.2% versus 25.0%, p = 0.02).

CONCLUSIONS

There is a high rate of alcohol and illicit drug use in patients who die from trauma, especially penetrating trauma in men aged 15 to 50 years, who are Hispanic or African American. Victims with penetrating trauma and positive toxicology are considerably more likely to have no vital signs on admission than victims with negative toxicology. Pedestrians killed by automobiles who had positive screens have a higher incidence of severe abdominal injuries than victims with negative screens.

摘要

背景

我和同事研究了创伤死亡病例中的酒精和非法药物中毒情况及其与损伤性质和严重程度的关联。

研究设计

我们检查了一家一级学术创伤中心所有创伤死亡病例的创伤登记资料和尸检情况。进行统计分析以评估物质使用与损伤严重程度评分、严重创伤身体部位（简明损伤评分≥3）和脊柱损伤之间的关联。

结果

2000年1月至2003年5月，发生了931例创伤死亡；对600名受害者进行了酒精和非法药物检测，其中256例（42.7%）检测呈阳性。男性受害者检测呈阳性的可能性显著高于女性患者（46.1%对26.7%，p = 0.0003）。穿透性创伤比钝性创伤更有可能与检测呈阳性相关（53.0%对31.0%，p < 0.001）。西班牙裔和非裔美国受害者检测呈阳性的可能性高于白种人或亚洲人。15至50岁年龄组的患者中有一半检测呈阳性。穿透性创伤且检测呈阳性的受害者在入院时死亡的可能性显著高于毒理学检测呈阴性的受害者（68.8%对48.8%，p = 0.叭）。被汽车撞死且检测呈阳性的行人比毒理学检测呈阴性的受害者更有可能发生严重腹部创伤（简明损伤评分≥3）（54.2%对25.0%，p = 0.02）。