Department of Emergency Medicine, Wright State University, Dayton, OH, United States of America.
Wright State University, Dayton, OH, United States of America.
Am J Emerg Med. 2022 Feb;52:8-12. doi: 10.1016/j.ajem.2021.11.035. Epub 2021 Nov 25.
The incidence of alcohol and recreational drug use is increasing. The impact on penetrating trauma is unknown. This study was undertaken to identify the incidence of alcohol and recreational drug use prior to penetrating trauma, and to identify ISS and outcomes among patients with penetrating trauma.
In this retrospective study, eligible subjects included trauma patients age 18 and older, with major trauma (admitted or evaluated by the Trauma Team) from 2017 to 2021. A chart review was conducted to identify data including mechanism of injury, ISS, alcohol level, toxicologic testing, length of stay, and final disposition.
Among 1270 adult subjects with penetrating trauma during 2017 through 2020, the majority were male (N = 1071; 84%), and African American (N = 679; 54.3%) or White (N = 537; 42.9%). Mechanisms of injury included gunshot wound (GSW) (N = 973; 76.6%) or stab wound (N = 297; 23.4%). Injury severity score (ISS) ranged from 1 to 75. Among 426 subjects (33.5%) tested for recreational drugs, 395 (93%) were positive for at least one substance. The most common recreational drugs identified included marijuana (N = 280; 65.7%), benzodiazepine ((N = 131;30.8%), alcohol ((N = 248; 25.3%), opiate ((N = 116; 27.2%), cocaine (N = 87; 20.4%), and amphetamine ((N = 84; 19.7%). Subjects with an ISS of 9 to 15 had higher odds of testing positive for opiates compared to subjects with an ISS of 1 to 3 (OR 2.3). Most patients were ultimately discharged home ((N = 912;71.8%) and a minority expired (N = 142; 11.2%).
Positive screens for alcohol and recreational drugs were common among penetrating trauma patients in this setting. The most common identified recreational drugs included marijuana, benzodiazepine, opiates, alcohol, cocaine, and amphetamine.
酒精和娱乐性药物的使用发生率正在上升。其对穿透性创伤的影响尚不清楚。本研究旨在确定穿透性创伤前酒精和娱乐性药物的使用发生率，并确定穿透性创伤患者的 ISS 和结局。
在这项回顾性研究中，合格的研究对象包括 2017 年至 2021 年间年龄在 18 岁及以上、有主要创伤（经创伤小组收治或评估）的成年患者。对病历进行了回顾性分析，以确定包括损伤机制、ISS、酒精水平、毒理学检测、住院时间和最终去向等数据。
在 2017 年至 2020 年期间的 1270 名穿透性创伤成年患者中，大多数为男性（N=1071；84%），非裔美国人（N=679；54.3%）或白人（N=537；42.9%）。损伤机制包括枪伤（N=973；76.6%）或刺伤（N=297；23.4%）。损伤严重程度评分（ISS）范围为 1 至 75。在 426 名（33.5%）接受娱乐性药物检测的患者中，有 395 名（93%）至少有一种物质呈阳性。最常见的娱乐性药物包括大麻（N=280；65.7%）、苯二氮䓬类（N=131；30.8%）、酒精（N=248；25.3%）、阿片类（N=116；27.2%）、可卡因（N=87；20.4%）和苯丙胺（N=84；19.7%）。ISS 为 9 至 15 的患者检测出阿片类药物呈阳性的几率高于 ISS 为 1 至 3 的患者（比值比 2.3）。大多数患者最终出院回家（N=912；71.8%），少数患者死亡（N=142；11.2%）。
在这种情况下，穿透性创伤患者中酒精和娱乐性药物的阳性筛查率很高。最常见的识别出的娱乐性药物包括大麻、苯二氮䓬类、阿片类、酒精、可卡因和苯丙胺。
