Recreational drugs and outcomes in trauma patients

Abstract

Objective: The objective of the study is to determine if marijuana, methamphetamine, or cocaine is associated with worse outcomes following trauma. Methods: A retrospective cross-sectional study was conducted on 731 trauma patients. Data collected from Natividad Medical Center's trauma registry were used to analyze reports of adult patients from July 1, 2014, to July 1, 2017. Analyzed endpoints were mortality, rates of major trauma, mean Injury Severity Score (ISS), and length of stay (LOS). Results: Odds ratios for mortality contained null value in each group. Odds ratios for suffering major trauma for marijuana and amphetamines were 1.2 and 2.6, respectively. P values for ISS were >0.05 for each group. P values for LOS were >0.05 for marijuana and cocaine and 0.01 for amphetamines. Conclusions: A positive screen for marijuana, amphetamine, or cocaine is not associated with increased mortality for victims of trauma. Amphetamines are associated with higher rates of major trauma and longer LOS. Marijuana is associated with higher rates of major trauma. Cocaine is not associated with the likelihood of suffering major trauma or length of stay.

The effect of illegal drug screening results and chronic drug use on perioperative complications in trauma

“…found that a positive screen for marijuana, amphetamine, or cocaine is not significantly associated with increased mortality for trauma patients. [ 4 ] In an ER study of 378 episodes of amphetamine intoxication, Isoardi et al . found that the complications were mainly behavioral and renal.…”

“…[ 1 2 ] In contrast to chronic use, there is little evidence that the results of drug screening affect the outcome. [ 3 4 5 ]…”

Urine drug screen positive for cocaine and amphetamine is not an adverse risk factor for cardiovascular morbidity or mortality in trauma

“… 1 There are also studies that show no significant difference in mortality or cardiovascular complications in trauma patients who test positive for stimulants. 13–16 This is further validated by recent studies examining the incidence of hemodynamic events under anesthesia to be similar between patients who screen positive for stimulants and patients who have a negative UDS, with the rates of vasopressor use during surgery similar between both groups. 17–19 …”

Trends and outcomes of trauma patients positive to marijuana and cocaine

“…Furthermore, some of the studies available show conflicting results on the subject. For example, some analyses have found an increase in mortality rates of marijuana positive patients [19], while others have reported the opposite [6] or no association [20][21][22][23]. This same pattern of results has been seen in the hospital length of stay (LOS) [20,[22][23][24][25][26][27][28], the Injury Severity Score (ISS) [19,26], and other important parameters.…”

“…For example, some analyses have found an increase in mortality rates of marijuana positive patients [19], while others have reported the opposite [6] or no association [20][21][22][23]. This same pattern of results has been seen in the hospital length of stay (LOS) [20,[22][23][24][25][26][27][28], the Injury Severity Score (ISS) [19,26], and other important parameters. Due to this lack of studies and the conflicting results from the available ones, there exists no clear scientific consensus regarding the impact of drug use on trauma patient outcomes.…”