Sergio Cordovilla-Guardia1, Pablo Lardelli-Claret2, Raquel Vilar-López3, Fidel López-Espuela4, Francisco Guerrero-López5, Enrique Fernández-Mondéjar5. 1. Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain; Doctoral Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain. Electronic address: cordovilla@unex.es. 2. Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain; CIBER of Epidemiology and Public Health, Granada, Spain; Instituto de Investigación Biosanitaria IBS, Granada, Spain. 3. Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain; Mind, Brain and Behavior Research Centre, University of Granada, Granada, Spain. 4. Nursing Department, Nursing and Occupational Therapy College, University of Extremadura, Cáceres, Spain. 5. Instituto de Investigación Biosanitaria IBS, Granada, Spain; Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de Granada, Granada, Spain.
Abstract
OBJECTIVE: The effect of drugs other than alcohol on severity of trauma remains unclear. Pooled data analyses in previous studies that grouped substances with opposite effects on the central nervous system (CNS) may have masked the influence of substances on injury severity. The aim was to analyze the effect of stimulant, hallucinogenic and depressant drugs other than alcohol on injury severity in trauma patients. METHODS: The presence of alcohol, stimulant drugs (cocaine, amphetamines and methamphetamines), depressant drugs (benzodiazepines, opiates, methadone and barbiturates) and hallucinogenic drugs (THC and PCP) was analyzed in 1187 patients between 16 and 70 years old admitted to a trauma hospital between November 2012 and June 2015. Injury severity was determined prospectively as the Injury Severity Score. A multivariate analysis was used to quantify the strength of association between exposure to substances and trauma severity, using the presence of alcohol as a stratification variable. RESULTS: Drugs other than alcohol were found in 371 patients (31.3%): 32 (2.7%) stimulants, 186 (15.3%) depressants, 78 (6.6%) hallucinogenics and 75 (5.6%) polydrug use. The presence of CNS depressant substances was associated with increased injury severity only in patients also exposed to alcohol, with an adjusted odds ratio of 4.63 (1.37-15.60) for moderate injuries and 7.83 (2.53-24.21) for severe. CONCLUSION: CNS depressant drugs had a strong influence on injury severity in patients who screened positive for alcohol consumption.
OBJECTIVE: The effect of drugs other than alcohol on severity of trauma remains unclear. Pooled data analyses in previous studies that grouped substances with opposite effects on the central nervous system (CNS) may have masked the influence of substances on injury severity. The aim was to analyze the effect of stimulant, hallucinogenic and depressant drugs other than alcohol on injury severity in traumapatients. METHODS: The presence of alcohol, stimulant drugs (cocaine, amphetamines and methamphetamines), depressant drugs (benzodiazepines, opiates, methadone and barbiturates) and hallucinogenic drugs (THC and PCP) was analyzed in 1187 patients between 16 and 70 years old admitted to a trauma hospital between November 2012 and June 2015. Injury severity was determined prospectively as the Injury Severity Score. A multivariate analysis was used to quantify the strength of association between exposure to substances and trauma severity, using the presence of alcohol as a stratification variable. RESULTS: Drugs other than alcohol were found in 371 patients (31.3%): 32 (2.7%) stimulants, 186 (15.3%) depressants, 78 (6.6%) hallucinogenics and 75 (5.6%) polydrug use. The presence of CNS depressant substances was associated with increased injury severity only in patients also exposed to alcohol, with an adjusted odds ratio of 4.63 (1.37-15.60) for moderate injuries and 7.83 (2.53-24.21) for severe. CONCLUSION: CNS depressant drugs had a strong influence on injury severity in patients who screened positive for alcohol consumption.