Detection of ethanol, cannabinoids, benzodiazepines, and opioids in older adults evaluated for serious injuries from falls.

IF 3 3区医学 Q2 TOXICOLOGY

Clinical Toxicology Pub Date : 2024-10-01 Epub Date: 2024-09-28 DOI:10.1080/15563650.2024.2400186

Kavita M Babu, Yara K Haddad, Shakiera T Causey, Carmen C Vargas-Torres, Patricia Mae Martinez, Elizabeth M Goldberg, Jon D Dorfman, Julia A Bleser, Brittany P Chapman, Jeffrey T Lai, Riyadh Saif, Romanda Elhoussan, Lindsey A Graham, Alex J Krotulski, Sara E Walton, F Dennis Thomas, Barry K Logan, Roland C Merchant

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引用次数: 0

Abstract

Background: In 2020, there were 36.7 million reported falls among older adults (65+) in the United States. Ethanol and other sedating substances may increase fall risk among older adults due to their effect on cognitive and physical function. We estimate the prevalence of these substances in blood specimens of older adults presenting with a fall injury at selected trauma centers.

Methods: The initial study collected blood specimens from May 2020 through July 2021 from adults undergoing a trauma team evaluation at selected United States Level 1 trauma centers. We limited our study to older adults evaluated after a fall (n = 1,365) and selected a random sample (n = 300) based on age, sex, and trauma-center quotas. Medical health records and blood specimens obtained at trauma center presentation were analyzed. We estimated the prevalence of ethanol, benzodiazepines, cannabinoids, and opioids in the blood specimens. Two-sample tests of binomial proportions and Chi-square two-tailed tests were used to compare prevalence estimates of substances by demographic characteristics.

Results: At least one substance was detected among 31.3% of samples analyzed. Prevalences of specific substances detected were 9.3% (95% CI: 6.0-12.6%) for benzodiazepines, 4.3% (95% CI: 2.0-6.7%) for cannabinoids, 8.0% (95% CI: 5.2-11.7%) for ethanol, and 15.0% (95% CI: 10.9-19.1%) for opioids. There were 18 deaths (6%; 95% CI: 3.6-9.3%). One-third of decedents had at least one substance detected in their blood.

Discussion: Opioids were the most frequently detected substance, followed by benzodiazepines, ethanol, and cannabinoids. Substance use prevalence was not uniform across demographics, with differences observed by sex and age.

Conclusions: This study provides insight into the frequency of the presence of substances that may contribute to fall risk and serious injury among older adults. Screening older adults for substances that impair cognitive and physical function can enhance clinical fall prevention efforts.

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检测因跌倒造成严重伤害而接受评估的老年人体内的乙醇、大麻类药物、苯二氮卓类药物和阿片类药物。

背景：2020 年，美国报告的老年人（65 岁以上）跌倒人数为 3,670 万。由于乙醇和其他镇静物质会影响认知和身体功能，因此可能会增加老年人跌倒的风险。我们估计了在选定的创伤中心就诊的跌倒受伤老年人的血液标本中这些物质的流行率：初步研究收集了 2020 年 5 月至 2021 年 7 月期间在选定的美国一级创伤中心接受创伤小组评估的成年人的血液标本。我们将研究对象限定为跌倒后接受评估的老年人（n = 1,365），并根据年龄、性别和创伤中心配额随机抽取样本（n = 300）。我们对医疗健康记录和在创伤中心就诊时获得的血液标本进行了分析。我们估算了血液样本中乙醇、苯二氮卓类、大麻类和阿片类药物的流行率。我们使用二项比例二样本检验和卡方双尾检验来比较不同人口统计学特征的药物流行率估计值：结果：31.3%的分析样本中至少检测出一种物质。苯二氮卓类药物的流行率为 9.3%（95% CI：6.0-12.6%），大麻类药物的流行率为 4.3%（95% CI：2.0-6.7%），乙醇的流行率为 8.0%（95% CI：5.2-11.7%），阿片类药物的流行率为 15.0%（95% CI：10.9-19.1%）。共有 18 人死亡（6%；95% CI：3.6-9.3%）。三分之一的死者血液中至少检测出一种物质：讨论：阿片类药物是最常检测到的药物，其次是苯二氮卓、乙醇和大麻类药物。不同人群的药物使用率不尽相同，性别和年龄也存在差异：这项研究有助于深入了解可能导致老年人跌倒风险和严重伤害的物质的存在频率。对老年人进行筛查，检查是否存在损害认知和身体功能的物质，可以加强临床预防跌倒的工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Toxicology 医学-毒理学

CiteScore

5.70

自引率

12.10%

发文量

148

审稿时长

4-8 weeks

期刊介绍： clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.