Burke Bridget A, Lewis Robert W, Latenser Barbara A, Chung Joseph Y, Willoughby Clark, Kealey G Patrick, Wibbenmeyer Lucy A
Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52240, USA.
J Burn Care Res. 2008 Jul-Aug;29(4):574-9. doi: 10.1097/BCR.0b013e31817db832.
Methamphetamine (MA) is a highly addictive drug that is easily manufactured from everyday household products and chemicals found at local farm stores. The proliferation of small MA labs has led to a dramatic increase in patients sustaining thermal injury while making and/or using MA. We hypothesized that these patients have larger injuries with longer hospital stays, and larger, nonreimbursed hospital bills compared with burn patients not manufacturing or using MA. In a retrospective case-control study, all burn patients >or=16 years of age admitted to our burn center from January 2002 to December 2005 were stratified into two groups based on urine MA status. Of the 660 burn patients >or=16 years of age admitted during this 4 year period, urine drug screens were obtained at admission on 410 patients (62%); 10% of urine drug screens were MA (+). MA (+) patients have larger burns compared with MA (-) patients (9.3 vs 8.6% body surface area burns), have higher rates of inhalation injuries (20.4 vs 9.3%, P = .015), and more nonthermal trauma (13.0 vs 3.1%, P = .001). When compared with MA (-) patients, MA (+) patients require longer hospital stays (median 9.5 vs 7.0 days, P = .036), accrue greater hospital bills per day (dollars 4292 vs dollars 2797, P = .01), and lack medical insurance (66.7 vs 17.7%, P < .0001). The epidemic of MA use and its manufacture mandates that burn centers monitor patients for MA use and develop and institute protocols to ensure proper care of this increasingly costly population.
甲基苯丙胺（MA）是一种极易成瘾的药物，它很容易由日常家居用品以及当地农资店所售的化学品制成。小型甲基苯丙胺制毒窝点的扩散导致在制造和/或使用甲基苯丙胺过程中遭受热损伤的患者数量急剧增加。我们推测，与不制造或使用甲基苯丙胺的烧伤患者相比，这些患者的损伤面积更大，住院时间更长，且医院账单更高且无法报销。在一项回顾性病例对照研究中，2002年1月至2005年12月期间入住我们烧伤中心的所有16岁及以上烧伤患者根据尿液甲基苯丙胺检测结果分为两组。在这4年期间收治的660例16岁及以上烧伤患者中，410例（62%）在入院时进行了尿液药物筛查；其中10%的尿液药物筛查呈甲基苯丙胺阳性（MA(+)）。与甲基苯丙胺检测阴性（MA(-)）的患者相比，MA(+)患者的烧伤面积更大（分别为9.3%和8.6%体表面积烧伤），吸入性损伤发生率更高（分别为20.4%和9.3%，P = 0.015），且非热损伤更多（分别为13.0%和3.1%，P = 0.001）。与MA(-)患者相比，MA(+)患者住院时间更长（中位数分别为9.5天和7.0天，P = 0.036），每天产生的医院账单更高（分别为4292美元和2797美元，P = 0.01），且没有医疗保险（分别为66.7%和17.7%，P < 0.0001）。甲基苯丙胺的使用及其制造问题流行，这就要求烧伤中心对患者的甲基苯丙胺使用情况进行监测，并制定和实施相关方案，以确保对这一成本日益增加的群体进行妥善治疗。
