Epidemic increases in cocaine and opiate use by trauma center patients: Documentation with a large clinical toxicology database
Epidemic increases in cocaine and opiate use by trauma center patients: Documentation with a large clinical toxicology database
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DOI：
10.1097/00005373-200109000-00024
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发表时间：
2001-09-01
影响因子：
--
通讯作者：
Scalea, TM
中科院分区：
文献类型：
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作者：
Soderstrom, CA;Dischinger, PC;Scalea, TM
背景 尽管有报告记录了创伤患者使用酒精和其他药物的情况，但尚未发表有关长期趋势的研究。我们评估了 1984 年 7 月至 2000 年 6 月期间入住地区一级成人创伤中心的一大群患者的药物使用趋势。方法。通过回顾性数据库审查收集的阳性毒理学结果对直接入院的患者进行了分析。数据取自 53,338 名患者的临床毒理学数据库。对酒精、可卡因和阿片类药物与性别、年龄（< 40/ 40 岁）和伤害类型（非暴力/暴力）的关系进行了分析。在该时期开始和结束时评估了 3 年的阳性毒理学测试结果趋势 (chi (2))。对性别、种族和伤害类型的测试偏差进行了评估。结果。患者概况如下：男性，72%；年龄<40岁，69%；非暴力受害者，77%。酒精阳性结果下降了 37%，但可卡因阳性和阿片类阳性结果分别增加了 212% 和 543%（全部 p < 0.001）。非暴力受害者的可卡因阳性/鸦片阳性结果分别增加了 152%/640%，暴力受害者的可卡因阳性/鸦片阳性结果分别增加了 226%/258%（所有 p < 0.001）。 2000 财政年度，暴力受害者中可卡因和阿片类药物呈阳性的比例最高（两种药物呈阳性的比例均为 27.4%）。非暴力受害者中可卡因和阿片类药物呈阳性的比例分别为 9.4% 和 17.6%。少数族裔或暴力受害者患者接受检测的频率并不高于其他患者。结论。据记录，所有创伤患者群体中可卡因和阿片类药物的使用量都在增加，其中暴力受害者的增加幅度最大。所有群体的饮酒量均有所下降。
Background Although reports have documented alcohol and other drug use by trauma patients, no studies of long-term trends have been published. We assessed substance use trends in a large cohort of patients admitted to a regional Level I adult trauma center between July 1984 and June 2000.Methods. Positive toxicology results, collected via retrospective database review, were analyzed for patients admitted directly to the center. Data were abstracted from a clinical toxicology database for 53,338 patients. Results were analyzed for alcohol, cocaine, and opiates relative to sex, age (< 40/ 40 years), and injury type (nonviolence/violence). Positive toxicology test result trends were assessed for the 3 years at the beginning and end of the period (chi (2)). Testing biases were assessed for sex, race, and injury type.Results. The patient profile was as follows: men, 72%; age < 40 years, 69%; nonviolence victims, 77%. Alcohol-positive results decreased 37%, but cocaine-positive and opiate-positive results increased 212% and 543%, respectively (all p < 0.001). Cocaine-positive/opiate-positive results increased 152%/640% for nonviolence and 226%/258% for violence victims, respectively (all p < 0.001). In fiscal year 2000, cocaine-positive and opiate-positive results were highest among violence victims (27.4% for both drugs). Cocaine-positive and opiate-positive results among nonviolence victims were 9.4% and 17.6%, respectively. Patients who were minorities or victims of violence were not tested more frequently than other patients.Conclusion. Epidemic increases in cocaine and opiate use were documented in all groups of trauma patients, with the greatest increases being in violence victims. Alcohol use decreased for all groups.