药物滥用如何影响创伤后的结果？一项创伤质量改善项目研究

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-04-01 DOI:10.1016/j.amjsurg.2025.116332

Aryan Rafieezadeh, Kartik Prabhakaran, Jordan Kirsch, Anna Jose, Bardiya Zangbar

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引用次数: 0

摘要

背景药物滥用对创伤后入住 ICU 和呼吸机断流的保护作用尚存争议。本研究探讨了药物滥用对死亡率、ICU 入院率和并发症的影响。方法分析了 TQIP 数据库（2020-2022 年）中接受入院毒理学检测 (TOX) 的年龄≥16 岁的创伤患者。结果在861,450名患者中，大麻类药物（OR = 0.842）、苯丙胺类药物（OR = 0.800）、可卡因类药物（OR = 0.851）、阿片类药物（OR = 0.625）和苯二氮卓类药物（OR = 0.843）的死亡率降低（P < 0.001）。阿片类药物（OR = 0.882）、巴比妥类药物（OR = 0.824）、羟考酮（OR = 0.829）、摇头丸（OR = 0.811）和美沙酮（OR = 0.809）可降低入住重症监护室的几率。阿片类药物（OR = 0.663）、巴比妥酸盐（OR = 0.733）、羟考酮（OR = 0.754）和摇头丸（OR = 0.627）的插管几率较低。结论娱乐性药物可独立减少 ICU 入院率、插管率和死亡率，值得进一步研究。

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How does drug abuse affect outcomes after trauma? A trauma quality improvement program study

Background

The protective effects of drug abuse on ICU admissions and ventilator weaning after trauma are debated. This study examines the impact of drug abuse on mortality, ICU admissions, and complications.

Methods

Trauma patients ≥16 years from the TQIP database (2020–2022) with admission toxicology testing (TOX) were analyzed. The primary outcome was mortality; secondary outcomes included in-hospital complications.

Results

Among 861,450 patients, decreased mortality odds were noted with cannabinoid (OR = 0.842), amphetamine (OR = 0.800), cocaine (OR = 0.851), opioid (OR = 0.625), and benzodiazepine (OR = 0.843) (P < 0.001). Reduced ICU admission odds were linked to opioid (OR = 0.882), barbiturate (OR = 0.824), oxycodone (OR = 0.829), ecstasy (OR = 0.811), and methadone (OR = 0.809). Lower intubation odds were seen with opioid (OR = 0.663), barbiturate (OR = 0.733), oxycodone (OR = 0.754), and ecstasy (OR = 0.627). Methamphetamine (OR = 0.682) was associated with reduced ARDS odds.

Conclusions

Recreational drugs may independently reduce ICU admissions, intubation, and mortality, warranting further investigation.

Level of evidence

Level III retrospective study.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.