精神活性物质与既往住院史对农村伤害患者分诊与住院时间的影响：一项前瞻性观察性研究。
Psychoactive substances and previous hospital admissions, triage and length of stay in rural injuries: a prospective observational study.
机构信息
Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, PO Box 6050, 9037, Tromsø, Norway.
Department of Forensic Sciences, Section for Drug Abuse Research, Oslo University Hospital, Lovisenberggaten 6, 0456, Oslo, Norway.
出版信息
Scand J Trauma Resusc Emerg Med. 2023 Nov 27;31(1):86. doi: 10.1186/s13049-023-01156-z.
BACKGROUND
Patients admitted to hospital after an injury are often found to have used psychoactive substances prior to the injury. The aim of this study was to investigate the associations between psychoactive substances (alcohol, psychoactive medicinal drugs and illicit drugs) and previous hospital admissions, triage and length of stay in the arctic Norwegian county of Finnmark.
METHODS
Patients ≥ 18 years admitted due to injury to trauma hospitals in Finnmark from January 2015 to August 2016 were approached. Parameters regarding admittance and hospital stay were collected from 684 patients and blood was analysed for psychoactive substances. Using a prospective, observational design, time, triage, length of stay in hospital, use of intensive care unit (ICU), injury severity, Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) and number of previous admittances were investigated by bivariable testing and logistical regression analysis.
RESULTS
Of 943 patients approached, 81% consented and 684 were included in the study. During the weekend, 51.5% tested positive for any substance versus 27.1% Monday-Friday. No associations were identified between testing positive and either triage or injury severity for any substance group although triage level was lower in patients with AUDIT-C ≥ 5. Short length of stay was associated with alcohol use prior to injury [odds ratio (OR) 0.48 for staying > 12 h, confidence interval (CI) 0.25-0.90]. The OR for staying > 24 h in the ICU when positive for an illicit substance was 6.33 (CI 1.79-22.32) while negatively associated with an AUDIT-C ≥ 5 (OR 0.30, CI 0.10-0.92). Patients testing positive for a substance had more often previously been admitted with the strongest association for illicit drugs (OR 6.43 (CI 1.47-28.08), compared to patients in whom no substances were detected.
CONCLUSIONS
Triage level and injury severity were not associated with psychoactive substance use. Patients using alcohol are more often discharged early, but illicit substances were associated with longer ICU stays. All psychoactive substance groups were associated with having been previously admitted.
背景
受伤后住院的患者通常在受伤前曾使用过精神活性物质。本研究旨在调查精神活性物质（酒精、精神活性药物和非法药物）与挪威北极芬马克郡以前的住院、分诊和住院时间之间的关系。
方法
2015 年 1 月至 2016 年 8 月，对因受伤而入住芬马克创伤医院的≥18 岁患者进行了评估。从 684 名患者中收集了入院和住院时间等参数，并对血液中的精神活性物质进行了分析。采用前瞻性观察设计，对时间、分诊、住院时间、重症监护病房（ICU）使用率、损伤严重程度、酒精使用障碍识别测试-消费（AUDIT-C）和以前的住院次数进行了单变量和逻辑回归分析。
结果
在 943 名接受评估的患者中，81%的患者同意参与研究，最终纳入 684 名患者。周末，有 51.5%的患者任何物质检测呈阳性，而周一至周五为 27.1%。任何物质组的阳性检测结果与分诊或损伤严重程度均无关联，尽管 AUDIT-C≥5 的患者分诊级别较低。受伤前有饮酒史的患者住院时间较短[受伤前有饮酒史的患者住院时间>12 小时的比值比（OR）为 0.48，95%置信区间（CI）为 0.25-0.90]。当 ICU 检测出非法物质阳性时，OR 为 6.33（95%CI 1.79-22.32），而与 AUDIT-C≥5 呈负相关（OR 0.30，95%CI 0.10-0.92）。检测出精神活性物质的患者以前住院的次数更多，其中非法药物的关联最强（OR 6.43（95%CI 1.47-28.08），与未检测到物质的患者相比。
结论
分诊级别和损伤严重程度与精神活性物质使用无关。使用酒精的患者通常更早出院，但非法药物与 ICU 停留时间较长有关。所有精神活性物质组都与以前的住院有关。
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