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创伤性脑损伤前饮酒和使用大麻对死亡率的综合影响。

The combined effects of alcohol and marijuana use prior to traumatic brain injury on mortality.

作者信息

Leskovan John J, Patel Puja D, Pederson John, Moore Aaron, Afaneh Amer, Brown Laura R

机构信息

Department of Trauma Surgery, Mercy St. Vincent Medical Center, Toledo, OH, USA.

Superior Medical Experts, Minneapolis, MN, USA.

出版信息

Ann Med Surg (Lond). 2020 Nov 27;60:639-643. doi: 10.1016/j.amsu.2020.11.059. eCollection 2020 Dec.

Abstract

BACKGROUND

Alcohol (ETOH) intoxication is a common comorbidity in traumatic brain injury (TBI), and marijuana (THC) has been implicated as a major risk factor for trauma. The objective this study was to investigate the combined effects of ETOH and THC on mortality after TBI.

MATERIALS AND METHODS

A retrospective review of patient data was performed to assess adult (>18 years) patients with brain injuries between January 2012 and December 2018. Included patients sustained TBI (Abbreviated Injury Scale (AIS 1-6)) and were divided into two groups: No Substances and THC + ETOH.

RESULTS

1085 (median age 52 years [range: 18-97 years]; 33.5% female (364/1085)) patients met the inclusion criteria. Significant differences for mortality at discharge were found between groups (p = 0.0025) with higher mortality in the No Substances group. On multiple logistic regression, a positive test for both ETOH + THC was found not to independently predict mortality at discharge, while age, Glasgow Coma Scale, intensive care unit stay, Injury Severity Score, length of hospital stay, and days on ventilator were independent predictors.

CONCLUSIONS

After controlling for confounding variables, positive ETOH + THC screens were not found to be independent predictors of mortality at discharge. Therefore, our results indicated no survival benefit for TBI patients with concomitant ETOH and THC use prior to injury.

摘要

背景

酒精(ETOH)中毒是创伤性脑损伤(TBI)中常见的合并症,大麻(THC)被认为是创伤的主要危险因素。本研究的目的是调查ETOH和THC对TBI后死亡率的联合影响。

材料与方法

对患者数据进行回顾性分析,以评估2012年1月至2018年12月期间成年(>18岁)脑损伤患者。纳入的患者患有TBI(简明损伤量表(AIS 1-6)),并分为两组:无物质组和THC + ETOH组。

结果

1085例(中位年龄52岁[范围:18-97岁];33.5%为女性(364/1085))患者符合纳入标准。两组间出院时死亡率存在显著差异(p = 0.0025),无物质组死亡率更高。在多因素逻辑回归分析中,发现ETOH + THC两者检测呈阳性并不能独立预测出院时的死亡率,而年龄、格拉斯哥昏迷量表、重症监护病房住院时间、损伤严重程度评分、住院时间和呼吸机使用天数是独立预测因素。

结论

在控制混杂变量后,未发现ETOH + THC检测呈阳性是出院时死亡率的独立预测因素。因此,我们的结果表明,受伤前同时使用ETOH和THC的TBI患者没有生存获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82bb/7718113/4988bd129084/gr1.jpg

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