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
{"title":"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。","authors":"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","doi":"10.1080/15563650.2024.2400186","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (<i>n</i> = 1,365) and selected a random sample (<i>n</i> = 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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10430,"journal":{"name":"Clinical Toxicology","volume":" ","pages":"661-668"},"PeriodicalIF":3.0000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Detection of ethanol, cannabinoids, benzodiazepines, and opioids in older adults evaluated for serious injuries from falls.\",\"authors\":\"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\",\"doi\":\"10.1080/15563650.2024.2400186\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 (<i>n</i> = 1,365) and selected a random sample (<i>n</i> = 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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":10430,\"journal\":{\"name\":\"Clinical Toxicology\",\"volume\":\" \",\"pages\":\"661-668\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Toxicology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/15563650.2024.2400186\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"TOXICOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Toxicology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/15563650.2024.2400186","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"TOXICOLOGY","Score":null,"Total":0}
Detection of ethanol, cannabinoids, benzodiazepines, and opioids in older adults evaluated for serious injuries from falls.
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.
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.
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