老年人创伤患者中甲基苯丙胺使用量的上升趋势。

The rising tide of methamphetamine use in elderly trauma patients.

机构信息

Trauma Service, Scripps Mercy Hospital, 4077 Fifth Avenue, San Diego, CA, 92103, USA.

出版信息

Am J Surg. 2021 Jun;221(6):1246-1251. doi: 10.1016/j.amjsurg.2021.02.030. Epub 2021 Mar 6.

DOI:10.1016/j.amjsurg.2021.02.030

PMID:33707080

Abstract

BACKGROUND

Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH's impact in elderly trauma patients.

METHODS

Retrospective analysis (2009-2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.

RESULTS

Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%-8%; p < 0.01). Elderly METH + patients were more likely to require surgical intervention (35% vs. 17%), mechanical ventilation (15% vs. 7%), and a longer hospitalization (6.5 vs. 3.6 days) compared with elderly substance negative. Multivariate analysis showed increasing age, ventilator use, and injury severity were associated with mortality (ps < 0.01); METH was not related to mortality.

CONCLUSION

Substance use in elderly trauma patients increased significantly. METH use in elderly trauma patients is a risk factor for significantly greater resource utilization.

摘要

背景

冰毒（METH）与受伤风险增加有关，老年人的结局尚不清楚。我们分析了 METH 对老年创伤患者的影响。

方法

对一级创伤中心的创伤患者进行回顾性分析（2009-2018 年）。老年患者定义为年龄≥55 岁。通过血液酒精测试和尿液药物筛查确定药物使用情况。使用 Cox 比例风险模型评估患者和损伤特征与死亡率的关系。

结果

在接受药物使用检测的 15770 例患者中，有 5278 例（34%）为老年患者。老年冰毒使用人数在过去的时间里增加了四倍（2%-8%；p<0.01）。与老年非药物使用组相比，老年 METH 使用组更有可能需要手术干预（35% vs. 17%）、机械通气（15% vs. 7%）和更长的住院时间（6.5 天 vs. 3.6 天）。多变量分析显示，年龄增加、使用呼吸机和损伤严重程度与死亡率相关（p<0.01）；METH 与死亡率无关。