Increased incidence of complications in trauma patients cointoxicated with alcohol and other drugs
Increased incidence of complications in trauma patients cointoxicated with alcohol and other drugs
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DOI：
10.1097/ta.0b013e318031aa7f
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发表时间：
2007-03-01
影响因子：
--
通讯作者：
Ahmed, Najma
中科院分区：
文献类型：
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作者：
Rootman, Daniel B.;Mustard, Robert;Ahmed, Najma
背景：酒精和药物中毒在创伤患者中很常见。尽管中毒和共中毒可产生一系列生理效应，但其对临床治疗的影响尚不清楚。目前的调查旨在评估酒精和药物使用的影响，以及这两种状态之间的相互作用对结果和院内并发症的影响。方法：所有在 5 年内损伤严重程度评分 (ISS) >= 12 且接受过酒精和其他药物测试的创伤患者均被纳入其中。将酒精阳性、药物阳性和两者都呈阳性的患者与测试阴性的患者进行比较。在控制年龄和 ISS 的情况下进行逻辑回归分析，以评估中毒或共中毒在确定临床结果和院内并发症中的相对贡献。结果：对于酒精阳性和药物阳性患者，中毒状态似乎不会影响结果。然而，发现同时中毒的个体总体并发症发生率增加（比值比 [OR] = 2.06），特别是肺炎发生率增加（OR = 3.34），机械通气需求发生率增加（OR = 2.37）。 结论：酒精和其他药物合并中毒是院内并发症增加的危险因素。
Background: Alcohol and drug intoxication is prevalent in trauma patients. Although intoxication and cointoxication can have a range of physiologic effects, their implications for clinical management are unclear. The current investigation aims to assess the effects of alcohol and substance use as well as the interaction between these two states on outcomes and in-hospital complications.Methods: All trauma patients with an Injury Severity Score (ISS) >= 12 during a 5-year period who were tested for both alcohol and other drugs were included. Alcohol-positive, drug-positive, and both-positive patients were compared with patients who tested negative. Logistic regression analysis was performed controlling for age and ISS to assess the relative contribution of intoxication or cointoxication in determining clinical outcomes and in-hospital complications.Results: For alcohol-positive and drug-positive patients, intoxication status did not appear to influence outcomes. However, cointoxicated individuals were found to have an increased incidence of complications overall (odds ratio [OR] = 2.06), an increased incidence of pneumonia specifically (OR = 3.34) and an increased incidence of the requirement for mechanical ventilation (OR = 2.37).Conclusions: Cointoxication with alcohol and other drugs is a risk factor for increased in-hospital complications.