Charles J DiMaggio1, Jacob B Avraham2, Spiros G Frangos3, Katherine Keyes4. 1. Department of Surgery, Division of Trauma and Acute Care Surgery, New York University School of Medicine, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States. 2. Department of Surgery, Division of Trauma and Acute Care Surgery, NorthShore University HealthSystem, Evanston, IL, United States. Electronic address: javraham@northshore.org. 3. Department of Surgery, Division of Trauma and Acute Care Surgery, New York University School of Medicine, New York, NY, United States. 4. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
Abstract
BACKGROUND: Alcohol and other drugs (AOD) increase the risk of traumatic injury occurring, but data suggest a protective benefit in preventing trauma-related mortality. The objective of this study is to describe the epidemiology of AOD-related traumatic injury in the US over a recent 7 year period and assess the interaction of traumatic injury and AOD on pre-admission fatality on both an additive scale using incidence contrasts and on a statistical multiplicative scale using survey-adjusted logistic regression. METHODS: Using the National Emergency Department Sample (NEDS), we describe the epidemiology of alcohol and substance-related emergency department traumatic injury over a recent period. AOD-related injury was assessed using survey-adjusted counts and means. Ratio estimates and differences were calculated using simulations based on survey-adjusted counts and standard errors. Differences in trends over time were evaluated by comparing the slopes of linear regression equations with year as the predictor variable. RESULTS: Alcohol and substance-related emergency department injury discharges increased 9.8 % during the study period. There was a statistically significant interaction between traumatic injury death and AOD on both an additive scale and multiplicative scale. (Odds Ratio for interaction term = 1.76, 95 % CI = 1.53, 2.03). CONCLUSIONS: AOD use does not provide a protective benefit in the setting of trauma, but rather is an important contributor to traumatic injury mortality.
BACKGROUND: Alcohol and other drugs (AOD) increase the risk of traumatic injury occurring, but data suggest a protective benefit in preventing trauma-related mortality. The objective of this study is to describe the epidemiology of AOD-related traumatic injury in the US over a recent 7 year period and assess the interaction of traumatic injury and AOD on pre-admission fatality on both an additive scale using incidence contrasts and on a statistical multiplicative scale using survey-adjusted logistic regression. METHODS: Using the National Emergency Department Sample (NEDS), we describe the epidemiology of alcohol and substance-related emergency department traumatic injury over a recent period. AOD-related injury was assessed using survey-adjusted counts and means. Ratio estimates and differences were calculated using simulations based on survey-adjusted counts and standard errors. Differences in trends over time were evaluated by comparing the slopes of linear regression equations with year as the predictor variable. RESULTS: Alcohol and substance-related emergency department injury discharges increased 9.8 % during the study period. There was a statistically significant interaction between traumatic injury death and AOD on both an additive scale and multiplicative scale. (Odds Ratio for interaction term = 1.76, 95 % CI = 1.53, 2.03). CONCLUSIONS: AOD use does not provide a protective benefit in the setting of trauma, but rather is an important contributor to traumatic injury mortality.
Authors: Patrick B Ryan; Paul E Stang; J Marc Overhage; Marc A Suchard; Abraham G Hartzema; William DuMouchel; Christian G Reich; Martijn J Schuemie; David Madigan Journal: Drug Saf Date: 2013-10 Impact factor: 5.606
Authors: C A Soderstrom; G S Smith; P C Dischinger; D R McDuff; J R Hebel; D A Gorelick; T J Kerns; S M Ho; K M Read Journal: JAMA Date: 1997-06-11 Impact factor: 56.272
Authors: Larry M Gentilello; Beth E Ebel; Thomas M Wickizer; David S Salkever; Frederick P Rivara Journal: Ann Surg Date: 2005-04 Impact factor: 12.969
Authors: Monica Sethi; Jessica H Heyer; Stephen Wall; Charles DiMaggio; Matthew Shinseki; Dekeya Slaughter; Spiros G Frangos Journal: Alcohol Date: 2016-04-09 Impact factor: 2.405