Stroh Gregory R, Dong Fanglong, Ablah Elizabeth, Ward Jeanette G, Haan James M
Am Surg. 2018 Mar 1;84(3):428-432.
The effects of methamphetamines (MAs) on trauma patient outcomes have been evaluated, but with discordant results. The purpose of this study was to identify hospital outcomes associated with MA use after traumatic injury. Retrospective review of adult trauma patients admitted to an American College of Surgeons verified-Level I trauma center who received a urine drug screen (UDS) between January 1, 2004 and December 31, 2013. Logistic regression analysis was used to identify factors associated with mortality. Patients with a negative UDS were used as controls. Among the 2321 patients included, 75.1 per cent were male, 81.9 per cent were white, and the average age was 39. Patients were grouped by UDS results (negative, MA only, other drug plus MA, or other drug without MA). A positive drug screen result of other drug without MA demonstrated a significantly lower risk for mortality, but longer intensive care unit and hospital length of stay, as well as increased ventilator days than negative results. Results of MA only did not alter the risk of mortality. These findings suggest that patients who test positive for MAs are not at an increased risk of in-hospital mortality when compared with patients having a negative drug screen.
甲基苯丙胺（MAs）对创伤患者预后的影响已得到评估，但结果并不一致。本研究的目的是确定创伤性损伤后使用MA相关的医院结局。对2004年1月1日至2013年12月31日期间入住美国外科医师学会认证的一级创伤中心并接受尿液药物筛查（UDS）的成年创伤患者进行回顾性研究。采用逻辑回归分析确定与死亡率相关的因素。UDS结果为阴性的患者作为对照。在纳入的2321例患者中，75.1%为男性，81.9%为白人，平均年龄为39岁。患者按UDS结果分组（阴性、仅MA、其他药物加MA或无MA的其他药物）。无MA的其他药物药物筛查结果呈阳性显示死亡率风险显著降低，但重症监护病房和住院时间更长，呼吸机使用天数也比阴性结果增加。仅MA的结果并未改变死亡风险。这些发现表明，与药物筛查结果为阴性的患者相比，MA检测呈阳性的患者院内死亡风险并未增加。
