THE IMPACT OF SUBSTANCE USE ON MORTALITY AND MORBIDITY FROM THERMAL-INJURY

Alcohol and drug use have been associated with increased mortality and morbidity from thermal injury. To determine whether substance users ( SUs) differed from controls, 398 burn patients were studied, of whom, 161 had a positive drug screen for either ethanol, cannabinoids, cocai ne metabolites, amphetamines, phencyclidine, or benzodiazepines. SUs v ersus controls showed no difference in age, but had a significantly gr eater percentage of total burn surface area (TBSA) (25 vs. 17%), inhal ation injury (29 vs, 7%), and mortality (14 vs. 3%). The alcohol users (AUs) and drug users (DUs) were similar in relation to sex, age, inha lation injury, percentage of TBSA, and type of burn. DU patients exper ienced the same increase in inhalation injury as the AU group compared to controls. The mortality of AU patients was twice that of DU patien ts and six times that of controls. The best independent predictors of death were age, inhalation injury, percentage of TBSA (p < 0.001), and ethanol use (p < 0.02).