Lee J Austin, Ochola Eric O, Sugut Janet, Ngila Beatrice, Ojuka Daniel K, Mello Michael J, Aluisio Adam R
Warren Alpert Medical School of Brown University, Department of Emergency Medicine. Providence, RI, USA.
Data Manager, Kenyatta National Hospital. Nairobi, Kenya.
Afr J Emerg Med. 2022 Dec;12(4):321-326. doi: 10.1016/j.afjem.2022.06.011. Epub 2022 Jul 20.
Trauma is a leading cause of morbidity and mortality in Kenya. In many countries, substance use is common among patients presenting with injuries to an emergency center (EC).
To describe the epidemiology of self-reported substance use among adult injured patients seeking ED care in Nairobi, Kenya.
This prospective cross-sectional study, assessed patients presenting with injuries to the Kenyatta National Hospital ED in Nairobi, Kenya from March through June of 2021. Data on substance use, injury characteristics and ED disposition were collected. Substances of interest were alcohol, stimulants, marijuana, and opiates. The Alcohol Use Disorders Identification Test-Concise (AUDIT-C) tool was used to characterize hazardous alcohol use.
A total of 1,282 patients were screened for participation, of which 646 were enrolled. Among participants, 322 (49.8%) reported substance use in the past month (AUDIT-C positive, stimulants, opiates, and/or marijuana). Hazardous alcohol use was reported by 271 (42.0%) patients who screened positive with AUDIT-C. Polysubstance use, (≥2 substances) was reported by 87 participants in the past month. Median time from injury to ED arrival was 13.1 h for all enrolees, and this number was significantly higher among substance users (median 15.4 h, IQR 5.5 - 25.5; = 0.029).
In the population studied, reported substance use was common with a substantial proportion of injured persons screening positive for hazardous alcohol use. Those with substance use had later presentations for injury care. These data suggest that ED programming for substance use disorder screening and care linkage could be impactful in the study setting.
创伤是肯尼亚发病和死亡的主要原因。在许多国家，急诊科（EC）收治的受伤患者中物质使用很常见。
描述在肯尼亚内罗毕寻求急诊护理的成年受伤患者自我报告的物质使用流行病学情况。
这项前瞻性横断面研究评估了2021年3月至6月在肯尼亚内罗毕肯雅塔国家医院急诊科就诊的受伤患者。收集了关于物质使用、损伤特征和急诊科处置的数据。感兴趣的物质包括酒精、兴奋剂、大麻和阿片类药物。使用酒精使用障碍识别测试简明版（AUDIT-C）工具来表征危险饮酒情况。
共筛选了1282名患者参与研究，其中646名被纳入。在参与者中，322人（49.8%）报告在过去一个月内有物质使用（AUDIT-C呈阳性，使用兴奋剂、阿片类药物和/或大麻）。271名（42.0%）AUDIT-C筛查呈阳性的患者报告有危险饮酒情况。87名参与者报告在过去一个月内使用了多种物质（≥2种物质）。所有纳入者从受伤到到达急诊科的中位时间为13.1小时，物质使用者的这一数字显著更高（中位时间15.4小时，四分位间距5.5 - 25.5；P = 0.029）。
在所研究的人群中，报告的物质使用很常见，相当一部分受伤者危险饮酒筛查呈阳性。有物质使用的人受伤后就诊较晚。这些数据表明，在研究环境中，针对物质使用障碍筛查和护理联系的急诊科规划可能会有成效。
