Dunham C Michael, Huang Gregory S, Chance Elisha A, Hileman Barbara M
Trauma, Critical Care, and General Surgery, St. Elizabeth Youngstown Hospital, Youngstown, USA.
Trauma and Neuroscience Research, St. Elizabeth Youngstown Hospital, Youngstown, USA.
Cureus. 2024 Apr 19;16(4):e58606. doi: 10.7759/cureus.58606. eCollection 2024 Apr.
Introduction The relationship between cigarette smoking and arterial carboxyhemoglobin (CoHb) in trauma activation patients has not been investigated. The aim was to determine if cigarette smoking is associated with drug abuse history and arterial CoHb levels. Methodology This is a retrospective review of level I trauma center activations aged 18-60 during 2018-2020. A medical record audit was performed to assess each patient's cigarette smoking and drug abuse history and admission arterial CoHb level. The CoHb levels and smoking history for each patient were used to construct a receiver operating characteristic curve. Results Of the 742 trauma activations aged 18-60, 737 (99.3%) had a documented cigarette smoking history. Smoking history was positive in 49.7% (366) and negative in 50.3% (371). The positive smoking proportion was greater in patients with a drug abuse history (63.9% (234/366)) than those with a negative history (31.0% (115/371); p<0.0001; odds ratio=4.0). In 717 patients with a CoHb value, the CoHb was higher in smokers (3.9±2.2%) than in non-smokers (0.5±0.4%; p<0.0001; Cohen d=2.2). A CoHb >1.5% was higher in smokers (93.3% (333/357)) than non-smokers (1.7% (6/360); p<0.0001; odds ratio=818.6). The receiver operating characteristic curve for the relationship between CoHb and cigarette smoking history showed an area under the curve of 0.980 (p<0.0001). Using an arterial CoHb level >1.5% to predict a positive smoking history and a CoHb level ≤1.5% to predict a non-smoking history, sensitivity was 93.3% (333/357), specificity was 98.3% (354/360), and accuracy was 95.8% (687/717). Conclusion Cigarette smoking in trauma activations aged 18-60 is associated with drug abuse history and increased arterial CoHb levels on trauma center arrival.
引言 创伤激活患者中吸烟与动脉碳氧血红蛋白（CoHb）之间的关系尚未得到研究。目的是确定吸烟是否与药物滥用史及动脉CoHb水平相关。方法 这是一项对2018 - 2020年期间年龄在18 - 60岁的一级创伤中心激活病例的回顾性研究。进行了病历审核，以评估每位患者的吸烟和药物滥用史以及入院时的动脉CoHb水平。利用每位患者的CoHb水平和吸烟史构建了受试者工作特征曲线。结果 在742例年龄在18 - 60岁的创伤激活病例中，737例（99.3%）有吸烟史记录。吸烟史阳性的占49.7%（366例），阴性的占50.3%（371例）。有药物滥用史的患者中吸烟阳性比例（63.9%（234/366））高于无药物滥用史的患者（31.0%（115/371）；p<0.0001；比值比 = 4.0）。在717例有CoHb值的患者中，吸烟者的CoHb水平（3.9±2.2%）高于非吸烟者（0.5±0.4%；p<0.0001；Cohen d = 2.2）。CoHb>1.5%的吸烟者比例（93.3%（333/357））高于非吸烟者（1.7%（6/360）；p<0.0001；比值比 = 818.6）。CoHb与吸烟史关系的受试者工作特征曲线下面积为0.980（p<0.0001）。以动脉CoHb水平>1.5%预测吸烟史阳性，CoHb水平≤1.5%预测吸烟史阴性，敏感性为93.3%（333/357），特异性为98.3%（354/360），准确性为95.8%（687/717）。结论 18 - 60岁创伤激活患者中的吸烟与药物滥用史相关，且在创伤中心就诊时动脉CoHb水平升高。
