THE PREVALENCE AND EFFECT OF ALCOHOL AND DRUG-ABUSE ON COHORT-MATCHEDCRITICALLY INJURED PATIENTS

A prospective study was undertaken at a Level I trauma center to evalu ate the prevalence of substance use among victims of major trauma, alo ng with the impact on clinical outcome. Five hundred sixteen patients had urine toxicology and blood alcohol screens performed and correlate d with pattern and severity of injury, hospital course, and outcome. T hree hundred seventy-one patients (71%) screened positive for alcohol or drugs, or both. Fifty-two per cent had positive alcohol screens, an d 42 per cent had positive drug screens (cocaine and opiates represent ed 91% of positive drug screens). Univariate analysis revealed pattern s of alcohol/drug use varied among subgroups according to demographics (less use among patients older than 55 years, females and Asians; mor e drug use in blacks; more alcohol use in Hispanics), mechanism of inj ury (non-use in blunt trauma patients and use of both in penetrating t rauma patients) and body region injured (non-use in head-injured patie nts). Septic complications and mortality were more correlative with se verity of injury, but not with use or non-use of alcohol or drugs. We conclude that alcohol and drug use remains a major comorbid factor in major trauma, and that injury prevention efforts should include a stro ng focus on counseling regarding these lifestyle choices.