Patterns of Alcohol and Drug Abuse in an Urban Trauma Center

Lindenbaum, Gary A.; Carroll, Stanton F.; Daskal, Ierachmiel; Kapusnick, Regina

doi:10.1097/00005373-198912000-00012

Cited by 102 publications

(28 citation statements)

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“…The majority of the men who used drugs reported marijuana/hashish use, a drug that has not demonstrated an association with incurring a violence-related injury [25,26]. Our models selecting only for marijuana/hashish users or marijuana/hashish and alcohol users, showed no significant differences between the groups.…”

Section: Discussionmentioning

confidence: 86%

“…Recent ED studies suggest that the combined effect of alcohol and drug use may increase the risk of a violent injury [23] but that the type of drug used can play a significant role. While cocaine combined with alcohol has been found to increase the incidence of a violent injury [24,25] substances such as cannabis and opiates may not [26]. Additionally, while there are clear differences between men’s and women’s drinking patterns [27,28] there is less evidence that alcohol use and the risk of injury differs by gender [16].…”

Section: Introductionmentioning

confidence: 99%

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Violence‐related injury and gender: The role of alcohol and alcohol combined with illicit drugs

Korcha

Cherpitel

Witbrodt

et al. 2013

Drug and Alcohol Review

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Background The positive relationship between alcohol use, gender and violence-related injury is well established. However, less is known about injuries when alcohol is used in combination with other drugs. Method Self-report information was collected on alcohol and illicit drug use in the six hours prior to a violence-related injury in probability samples of patients presenting to emergency departments (n=9686). Results Patients with violence-related injuries reported the highest rates of alcohol use (49% of men; 23% of women) and alcohol use combined with illicit drugs (8% of men; 4% of women) prior to the injury event while non-violent injury patients reported lower rates of alcohol use (17% of men; 8% of women) and alcohol use combined with drugs (2% for men; 1% for women). Marijuana/hashish was the most commonly reported drug. The odds of a violent injury were increased when alcohol was used (men: odds ratio [OR]=5.4, 95% confidence interval [CI] 4.6–6.3; women: OR=4.0, 95% CI 3.0–5.5) or when alcohol was combined with illicit drug use prior to the injury (men: OR=6.6, 95% CI 4.7–9.3; women: OR=5.7, 95% CI=2.7–12.2) compared to non-users. No significant change in the odds of a violent injury was observed for men or women when alcohol users were compared with alcohol and drug users. Conclusion The positive association between alcohol and violent injury does not appear to be altered by the added use of drugs. Additional work is needed to understand the interpersonal, contextual and cultural factors related to substance use to identify best prevention practices and develop appropriate policies.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Violence‐related injury and gender: The role of alcohol and alcohol combined with illicit drugs

Korcha

Cherpitel

Witbrodt

et al. 2013

Drug and Alcohol Review

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“…To make the situation even more complex, neurological responses after TBI can vary over time for several reasons. Trauma is frequently associated with intoxication by alcohol or drugs; in the setting of a U.S. urban trauma center, Ͼ74% of trauma patients tested positive for illicit or prescription drugs in their blood (Lindenbaum et al, 1989). A review of studies evaluating the coexistence of alcohol intoxication and TBI found a rate of intoxication at the time of injury of 36-51% (Corrigan, 1995).…”

Section: Inaccurate Early Neurological Assessment In Head Injurymentioning

confidence: 99%

Inaccurate Early Assessment of Neurological Severity in Head Injury

Stocchetti¹,

Pagan²,

Calappi³

et al. 2004

J Neurotrauma

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Intubation, which requires sedation and myorelaxants, may lead to inaccurate neurological evaluation of severely head-injured patients. Aims of this study were to describe the early clinical evolution of traumatic brain injured (TBI) patients admitted to intensive care unit (ICU), to identify cases of over-estimated neurological severity, and to quantify the risk factors for this over-estimation. A total of 753 TBI patients consecutively admitted to ICU of three academic neurosurgical hospitals (NSH) were assessed. Cases whose severity was potentially over-estimated were identified by four criteria and indicated as "mistakenly severe" (MS): (1) no surgical intracranial masses; (2) could not follow commands at neurological assessment; (3) were dismissed from the ICU in Յ3 days to a regular ward; and (4) had regained the ability to obey commands. A total of 675 patients were intubated and/or sedated-paralyzed at the post-stabilization evaluation. In all, 304 patients had surgically treated intracranial masses. Among the 449 non-surgical cases, 58 patients fulfilling the criteria for MS were identified. The main features distinguishing MS from truly severe cases were younger age, higher Glasgow Coma Scale (GCS) score at all time points, Marshall classification of Computerized Tomographic (CT) scan mostly Diffuse Injury I and II, fewer pupillary abnormalities, and a lower frequency of hypoxia, hypotension, and extra-cranial injuries. In a certain proportion of non-surgical TBI patients, mostly intubated and sedated, neurological examination is difficult and severity can be over-estimated. Risk factors for this inaccurate evaluation can be identified, and clinical decisions should be based on further examination.

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“…Studies of the risk factors related to injuries are usually based on analyses of the subjects in high-risk groups. Such studies have identified the following factors: patterns of drinking,2-6 substance use (prescription/over-the-counter medication or illicit substances)7,8 and risk-taking behavior by the person who was injured 9-14. Studies have also reported that parental behavior is a risk factor for injuries in preschool age children 12-14…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Influencing the Occurrence of Injuries in Koreans Requiring Hospitalization

2007

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PurposeThis study focused on local communities and the factors influencing injuries requiring hospital admission that affect the quality of life for Koreans.Materials and MethodsThis study used data collected from 4,400 households during the 2001 Korea National Health and Nutrition Examination Survey (KNHANES). A stratified multistage probability sampling method was applied and the final sample included 7,924 subjects over 20 years old who had completed the questionnaire regarding factors influencing injuries requiring hospital admission. Multiple logistic regression analysis was used to estimate the risk factors influencing injuries.ResultsThe incidence of injuries requiring hospital admission in Koreans was higher in men than in women at 2.3% (95% CI: 1.8-2.8) and 1.7% (95% CI: 1.3-2.1), respectively. Statistically significant factors affecting the occurrence of injuries requiring hospital admission were marital status (OR: 2.60, 95% CI: 2.22-5.56), state of health (OR: 0.63, 95% CI: 0.43-0.92), frequency of heavy drinking (OR: 1.96, 95% CI: 1.01-3.79), normal physical activities (OR: 1.68, 95% CI: 1.07-2.65), and sleep (OR: 1.54, 95% CI: 1.01-2.35).ConclusionThe results of this study can be used to develop measures to prevent fatal injuries and be used as basic data for community health programs.

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Patterns of Alcohol and Drug Abuse in an Urban Trauma Center

Cited by 102 publications

References 0 publications

Violence‐related injury and gender: The role of alcohol and alcohol combined with illicit drugs

Violence‐related injury and gender: The role of alcohol and alcohol combined with illicit drugs

Inaccurate Early Assessment of Neurological Severity in Head Injury

Risk Factors Influencing the Occurrence of Injuries in Koreans Requiring Hospitalization

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