Urmil Pandya1, Michael Shay O'Mara2, William Wilson3, Judy Opalek2, Michael Lieber2. 1. Trauma Services, Grant Medical Center, Columbus, Ohio. Electronic address: urmil.pandya@ohiohealth.com. 2. Trauma Services, Grant Medical Center, Columbus, Ohio. 3. Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio.
Abstract
BACKGROUND: The prevalence of prescription narcotic use in the United States is on the rise. Opioid use and its impact on the management of trauma patients has yet to be thoroughly studied. The aim of this study was to determine the prevalence of preinjury opioid use and its influence on specific outcomes among the trauma patient population. METHODS: A retrospective review of all trauma patients presenting to a level 1 trauma center was performed from January 1, 2010-December 31, 2010. Patients who died within 24 h of presentation and those with incomplete medication data were excluded. Electronic medical record review of history and physical documentation and urine drug screen records were used to determine preinjury opioid status. Preexisting narcotic use, demographic data, injury mechanism and severity, injury type, and outcome variables were analyzed. RESULTS: A total of 3953 patients met inclusion criteria. Among our sample, 644 (16.3%) were positive for preinjury opioid use. Patients in the preinjury opioid group were older (48 versus 41 y) and more likely to be female (37.9% versus 30.6%). The mechanism of injury was more often falls (32.8% versus 22.0%). Analysis of less severely injured patients (ISS <15) found a significantly increased length of stay (3.7 versus 2.9 d) in the narcotics group. Evaluation of injury type revealed that head injury, abdominal injury, and lower extremity and/or pelvic injuries had significantly increased length of stay. CONCLUSIONS: There is a considerable prevalence of preinjury opioid use in the trauma population. These patients have unique characteristics and causes of injury. Preinjury opioid use is predictive of increased length of stay, with important ramifications for patient care and health care costs.
BACKGROUND: The prevalence of prescription narcotic use in the United States is on the rise. Opioid use and its impact on the management of traumapatients has yet to be thoroughly studied. The aim of this study was to determine the prevalence of preinjury opioid use and its influence on specific outcomes among the traumapatient population. METHODS: A retrospective review of all traumapatients presenting to a level 1 trauma center was performed from January 1, 2010-December 31, 2010. Patients who died within 24 h of presentation and those with incomplete medication data were excluded. Electronic medical record review of history and physical documentation and urine drug screen records were used to determine preinjury opioid status. Preexisting narcotic use, demographic data, injury mechanism and severity, injury type, and outcome variables were analyzed. RESULTS: A total of 3953 patients met inclusion criteria. Among our sample, 644 (16.3%) were positive for preinjury opioid use. Patients in the preinjury opioid group were older (48 versus 41 y) and more likely to be female (37.9% versus 30.6%). The mechanism of injury was more often falls (32.8% versus 22.0%). Analysis of less severely injured patients (ISS <15) found a significantly increased length of stay (3.7 versus 2.9 d) in the narcotics group. Evaluation of injury type revealed that head injury, abdominal injury, and lower extremity and/or pelvic injuries had significantly increased length of stay. CONCLUSIONS: There is a considerable prevalence of preinjury opioid use in the trauma population. These patients have unique characteristics and causes of injury. Preinjury opioid use is predictive of increased length of stay, with important ramifications for patient care and health care costs.
Authors: Katherine B Santosa; Yen-Ling Lai; Chad M Brummett; Jeremie D Oliver; Hsou-Mei Hu; Michael J Englesbe; Emilie M Blair; Jennifer F Waljee Journal: J Gen Intern Med Date: 2020-08-03 Impact factor: 5.128
Authors: Evelyn I Truong; Sami K Kishawi; V P Ho; Roshan S Tadi; David F Warner; Jeffrey A Claridge; Esther S Tseng Journal: Injury Date: 2021-03-10 Impact factor: 2.687
Authors: Brittany E Punches; Uwe Stolz; Caroline E Freiermuth; Rachel M Ancona; Samuel A McLean; Stacey L House; Francesca L Beaudoin; Xinming An; Jennifer S Stevens; Donglin Zeng; Thomas C Neylan; Gari D Clifford; Tanja Jovanovic; Sarah D Linnstaedt; Laura T Germine; Kenneth A Bollen; Scott L Rauch; John P Haran; Alan B Storrow; Christopher Lewandowski; Paul I Musey; Phyllis L Hendry; Sophia Sheikh; Christopher W Jones; Michael C Kurz; Nina T Gentile; Meghan E McGrath; Lauren A Hudak; Jose L Pascual; Mark J Seamon; Erica Harris; Anna M Chang; Claire Pearson; David A Peak; Roland C Merchant; Robert M Domeier; Niels K Rathlev; Brian J O'Neil; Leon D Sanchez; Steven E Bruce; Robert H Pietrzak; Jutta Joormann; Deanna M Barch; Diego A Pizzagalli; Jordan W Smoller; Beatriz Luna; Steven E Harte; James M Elliott; Ronald C Kessler; Kerry J Ressler; Karestan C Koenen; Michael S Lyons Journal: PLoS One Date: 2022-09-23 Impact factor: 3.752