Jason Duong1, Christopher Elia2, Ariel Takayanagi3, Taylor Lanzilotta4, Ajay Ananda5, Dan Miulli6. 1. Department of Neurosurgery, Riverside University Health System, United States. Electronic address: jason.duong@ruhealth.org. 2. Department of Neurosurgery, Riverside University Health System, United States. Electronic address: c.elia@ruhealth.org. 3. Touro University California, College of Osteopathic Medicine, United States. Electronic address: Ariel.takayanagi@tu.edu. 4. California Baptist University, Health Science, United States. Electronic address: tlanzilotta@calbaptist.edu. 5. Department of Neurosurgery, Kaiser Permanente Los Angeles Medical Center, United States. Electronic address: Ajay.K.Ananda@kp.org. 6. Department of Neurosurgery, Riverside University Health System, United States; Department of Neurosurgery, Arrowhead Regional Medical Center, United States. Electronic address: MiulliD@armc.sbcounty.gov.
Abstract
OBJECTIVE: Both neurotoxic and neuroprotective effects of methamphetamines (METH) are being studied. There are few studies evaluating the effects of METH on patients with traumatic brain injury (TBI). The objective of this study is to compare clinical outcomes after TBI in METH users versus non-METH users. PATIENT AND METHODS: A retrospective review of 304 patients with severe traumatic head injury were performed. Patients were evaluated and stratified based on toxicology screening for methamphetamines (METH) or none. Of the patients reviewed with a full toxicology, 24 of those patients were positive for METH, and 60 patients were negative. Patients were evaluated based on demographics, type of injury, Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS). RESULTS: METH patients were younger upon presentation (43.5 versus 55.8, p = 0.003), with a larger improvement in GCS and GOS upon discharge (P = 0.012, 0.0001 respectively). There was no significant difference in length of hospital stay, initial presenting GCS and GOS, or discharge GCS and GOS. CONCLUSIONS: Our findings demonstrate an improved change in GCS and GOS for those positive with METH than those without. Surprisingly, substance positive patients did not have a worse outcome score. Further investigation is necessary to evaluate the potential neuro-protective effects of METH in TBI.
OBJECTIVE: Both neurotoxic and neuroprotective effects of methamphetamines (METH) are being studied. There are few studies evaluating the effects of METH on patients with traumatic brain injury (TBI). The objective of this study is to compare clinical outcomes after TBI in METH users versus non-METH users. PATIENT AND METHODS: A retrospective review of 304 patients with severe traumatic head injury were performed. Patients were evaluated and stratified based on toxicology screening for methamphetamines (METH) or none. Of the patients reviewed with a full toxicology, 24 of those patients were positive for METH, and 60 patients were negative. Patients were evaluated based on demographics, type of injury, Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS). RESULTS:METHpatients were younger upon presentation (43.5 versus 55.8, p = 0.003), with a larger improvement in GCS and GOS upon discharge (P = 0.012, 0.0001 respectively). There was no significant difference in length of hospital stay, initial presenting GCS and GOS, or discharge GCS and GOS. CONCLUSIONS: Our findings demonstrate an improved change in GCS and GOS for those positive with METH than those without. Surprisingly, substance positive patients did not have a worse outcome score. Further investigation is necessary to evaluate the potential neuro-protective effects of METH in TBI.
Authors: Antonio Verduzco-Mendoza; Paul Carrillo-Mora; Alberto Avila-Luna; Arturo Gálvez-Rosas; Adriana Olmos-Hernández; Daniel Mota-Rojas; Antonio Bueno-Nava Journal: Front Neurosci Date: 2021-06-24 Impact factor: 4.677