Division of General Surgery, Department of Surgery, London Health Sciences Center, London, Ontario, Canada.
Ther Drug Monit. 2011 Aug;33(4):439-42. doi: 10.1097/FTD.0b013e318222d951.
There is a paucity of research on substance use in the pediatric trauma population. This study aims to describe trends in substance use and screening in the Canadian pediatric trauma population.
A retrospective review of the London Health Sciences Centre trauma database from April 1999 to January 2009 identified patients less than 18 years old admitted after major trauma [injury severity score (ISS) > 12]. Data extracted included age, gender, ISS, blood alcohol concentration (BAC), and results of toxicology screens.
BAC data were available for 799 patients and toxicology screens for 761 patients. BAC testing was completed in 30% (21% positive). Toxicology screens were completed in 7% (44% positive). Increasing age was associated with screening for alcohol (odds ratio = 1.4; 95% confidence interval 1.3-1.5). Screening for drug use had a bimodal distribution, with no children aged 4-10 years screened. Those screened for drugs and alcohol had a significantly higher ISS than those not tested (BAC 28 versus 23, P < 0.001, toxin screening 29 versus 24, P = 0.003). The most common ingestions were alcohol, benzodiazepines, cannabinoids, and opiates.
Screening for drugs and alcohol is sporadic in the pediatric trauma population. Further study utilizing a universal approach to drug and alcohol screening is needed to further delineate the true prevalence of substance use in this population.
在儿科创伤人群中，关于物质使用的研究很少。本研究旨在描述加拿大儿科创伤人群中物质使用和筛查的趋势。
对 1999 年 4 月至 2009 年 1 月伦敦健康科学中心创伤数据库进行回顾性分析，确定因严重创伤（损伤严重程度评分[ISS] > 12）入院的 18 岁以下患者。提取的数据包括年龄、性别、ISS、血液酒精浓度（BAC）和毒物筛查结果。
799 例患者有 BAC 数据，761 例患者有毒物筛查数据。完成 BAC 检测的占 30%（阳性率为 21%）。完成毒物筛查的占 7%（阳性率为 44%）。年龄增长与酒精筛查呈正相关（比值比=1.4；95%置信区间 1.3-1.5）。药物筛查呈双峰分布，无 4-10 岁儿童接受筛查。接受药物和酒精筛查的患者 ISS 明显高于未接受检测的患者（BAC 为 28 比 23，P < 0.001，毒素筛查为 29 比 24，P = 0.003）。最常见的摄入物为酒精、苯二氮䓬类、大麻素和阿片类药物。
儿科创伤人群中药物和酒精筛查较为零星。需要进一步研究，采用通用方法进行药物和酒精筛查，以进一步明确该人群中物质使用的真实流行率。
