Department of Surgery, Division of Trauma and Acute Care Surgery, New York University School of Medicine, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States.
Department of Surgery, Division of Trauma and Acute Care Surgery, NorthShore University HealthSystem, Evanston, IL, United States.
Drug Alcohol Depend. 2021 Aug 1;225:108763. doi: 10.1016/j.drugalcdep.2021.108763. Epub 2021 May 21.
Alcohol and other drugs (AOD) increase the risk of traumatic injury occurring, but data suggest a protective benefit in preventing trauma-related mortality. The objective of this study is to describe the epidemiology of AOD-related traumatic injury in the US over a recent 7 year period and assess the interaction of traumatic injury and AOD on pre-admission fatality on both an additive scale using incidence contrasts and on a statistical multiplicative scale using survey-adjusted logistic regression.
Using the National Emergency Department Sample (NEDS), we describe the epidemiology of alcohol and substance-related emergency department traumatic injury over a recent period. AOD-related injury was assessed using survey-adjusted counts and means. Ratio estimates and differences were calculated using simulations based on survey-adjusted counts and standard errors. Differences in trends over time were evaluated by comparing the slopes of linear regression equations with year as the predictor variable.
Alcohol and substance-related emergency department injury discharges increased 9.8 % during the study period. There was a statistically significant interaction between traumatic injury death and AOD on both an additive scale and multiplicative scale. (Odds Ratio for interaction term = 1.76, 95 % CI = 1.53, 2.03).
AOD use does not provide a protective benefit in the setting of trauma, but rather is an important contributor to traumatic injury mortality.
酒精和其他药物（AOD）会增加创伤性损伤的风险，但数据表明它们在预防与创伤相关的死亡率方面具有保护作用。本研究的目的是描述美国最近 7 年期间与 AOD 相关的创伤性损伤的流行病学，并评估创伤和 AOD 对入院前死亡率的相互作用，既使用发生率对比在加性尺度上进行描述，也使用经过调查调整的逻辑回归在统计乘法尺度上进行评估。
使用国家急诊部样本（NEDS），我们描述了近期酒精和物质相关急诊部创伤性损伤的流行病学。使用经过调查调整的计数和平均值评估 AOD 相关损伤。使用基于经过调查调整的计数和标准误差的模拟计算比率估计值和差异。通过比较线性回归方程的斜率与年份作为预测变量，评估随时间变化的趋势差异。
在研究期间，酒精和物质相关急诊部损伤出院人数增加了 9.8%。在加性尺度和乘法尺度上，创伤性死亡和 AOD 之间存在统计学显著的相互作用。（交互项的优势比=1.76，95%置信区间=1.53，2.03）。
在创伤情况下，AOD 的使用并没有提供保护作用，而是导致创伤性损伤死亡率的重要因素。
