Cordovilla-Guardia Sergio, Vilar-López Raquel, Lardelli-Claret Pablo, Guerrero-López Francisco, Fernández-Mondéjar Enrique
Sergio Cordovilla-Guardia, MSN, is Graduate Teaching Assistant, Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, and PhD Student, Doctoral Program in Clinical Medicine and Public Health, University of Granada, Spain. Raquel Vilar-López, PhD, is Associate Professor, Department of Psychology, Brain, Mind and Behavior Research Center, Red de Trastornos Adictivos, University of Granada, Spain. Pablo Lardelli-Claret, PhD, is Professor, Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Spain, and Member of the CIBER Epidemiology and Public Health Research Network, Spain. Francisco Guerrero-López, PhD, is Research Scientist; and Enrique Fernández-Mondéjar, PhD, is Research Scientist, Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de Granada, and Member of the Instituto de Investigación Biosanitaria IBS, Granada, Spain.
Nurs Res. 2017 Sep/Oct;66(5):399-404. doi: 10.1097/NNR.0000000000000231.
Alcohol, illicit drugs, and psychotropic medications are well-known causes of traumatic events. However, the association of each type of substance with trauma recidivism remains unclear.
The purpose of this study was to quantify the strength of associations between the type of substance detected in patients admitted for traumatic injury and trauma recidivism, defined as a documented history of past trauma.
The presence of alcohol and drugs (cannabis, cocaine, amphetamines, methamphetamines, benzodiazepines, opiates, methadone, barbiturates, and tricyclic antidepressants) was analyzed in 1,156 patients between 16 and 70 years old, hospitalized in a trauma hospital between November 2011 and March 2015. Their past trauma history was retrieved from the health information system, which included patient health histories since 1999. Multinomial logistic regression analysis was used to estimate the strength of the association between types of substances detected in current trauma patients and trauma recidivism (documented history of past trauma).
At least one substance was detected in 521 patients (45.1%): only alcohol in 159 (13.7%), only cannabis in 62 (5.4%), only psychotropic medications/opioids in 145 (12.5%), only cocaine/amphetamines in 14 (1.2%), and a combination of these groups in 141 (12.2%). The consumption of alcohol, illicit drugs, and/or psychotropic medications was associated with increased recidivism in all substance groups; the adjusted odds ratio for multiple recidivism was 3.17 (95% CI [2.29, 4.39]).
Patients who screened positive for alcohol, illicit drugs, and/or psychotropic medications had a higher frequency of past trauma history compared with patients with negative tests, independently of age, gender, or the presence of previous psychiatric disorders.
酒精、非法药物和精神药物是创伤事件的众所周知的原因。然而，每种物质类型与创伤复发之间的关联仍不清楚。
本研究的目的是量化因创伤性损伤入院患者中检测到的物质类型与创伤复发（定义为有既往创伤的记录史）之间关联的强度。
对2011年11月至2015年3月期间在一家创伤医院住院的1156名16至70岁患者的酒精和药物（大麻、可卡因、苯丙胺、甲基苯丙胺、苯二氮卓类、阿片类、美沙酮、巴比妥类和三环类抗抑郁药）存在情况进行了分析。他们的既往创伤史从健康信息系统中获取，该系统包括自1999年以来的患者健康史。采用多项逻辑回归分析来估计当前创伤患者中检测到的物质类型与创伤复发（既往创伤的记录史）之间关联的强度。
521名患者（45.1%）检测到至少一种物质：仅酒精159名（13.7%），仅大麻62名（5.4%），仅精神药物/阿片类145名（12.5%），仅可卡因/苯丙胺14名（1.2%），这些组的组合141名（12.2%）。酒精、非法药物和/或精神药物的使用与所有物质组中复发率的增加相关；多次复发的调整优势比为3.17（95%CI[2.29,4.39]）。
与检测结果为阴性的患者相比，酒精、非法药物和/或精神药物筛查呈阳性的患者既往创伤史的发生率更高，与年龄、性别或既往精神疾病无关。
