The rising tide of methamphetamine use in elderly trauma patients
Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH’s impact in elderly trauma patients. Retrospective analysis (2009–2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Subst...
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| Veröffentlicht in: | The American journal of surgery 2021-06, Vol.221 (6), p.1246-1251 |
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| container_title | The American journal of surgery |
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| creator | Benham, Derek A. Rooney, Alexandra S. Calvo, Richard Y. Carr, Matthew J. Diaz, Joseph A. Sise, C. Beth Bansal, Vishal Sise, Michael J. Martin, Matthew J. |
| description | Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH’s impact in elderly trauma patients.
Retrospective analysis (2009–2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.
Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%–8%; p |
| doi_str_mv | 10.1016/j.amjsurg.2021.02.030 |
| format | Article |
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Retrospective analysis (2009–2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.
Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%–8%; p < 0.01). Elderly METH + patients were more likely to require surgical intervention (35% vs. 17%), mechanical ventilation (15% vs. 7%), and a longer hospitalization (6.5 vs. 3.6 days) compared with elderly substance negative. Multivariate analysis showed increasing age, ventilator use, and injury severity were associated with mortality (ps < 0.01); METH was not related to mortality.
Substance use in elderly trauma patients increased significantly. METH use in elderly trauma patients is a risk factor for significantly greater resource utilization.
•Substance abuse rates are increasing in elderly trauma patients, including METH.•METH use by elderly trauma patients is a risk for using more hospital resources.•Elderly trauma patients should be screened for substances to fully inform care.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2021.02.030</identifier><identifier>PMID: 33707080</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Alcohol ; Assaults ; Blood alcohol level ; Chromatography ; Drug screening ; Drug use ; Geriatric trauma ; Geriatrics ; Health risks ; Hospitals ; Impact analysis ; Injuries ; Injury analysis ; Intoxication ; Length of stay ; Marijuana ; Mass spectrometry ; Mechanical ventilation ; Methamphetamine ; Mortality ; Multivariate analysis ; Older people ; Patients ; Resource utilization ; Risk analysis ; Risk factors ; Scientific imaging ; Statistical models ; Substance use ; Tetrahydrocannabinol ; THC ; Toxicology ; Trauma ; Trends ; Urine</subject><ispartof>The American journal of surgery, 2021-06, Vol.221 (6), p.1246-1251</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-64ba310927c7677b3e613f509688636fbae9e84eccf15a0c24580ec36203362a3</citedby><cites>FETCH-LOGICAL-c459t-64ba310927c7677b3e613f509688636fbae9e84eccf15a0c24580ec36203362a3</cites><orcidid>0000-0003-4701-8999 ; 0000-0001-9147-2668 ; 0000-0003-3362-0102 ; 0000-0002-4792-9701 ; 0000-0001-5832-783X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2529826474?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33707080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benham, Derek A.</creatorcontrib><creatorcontrib>Rooney, Alexandra S.</creatorcontrib><creatorcontrib>Calvo, Richard Y.</creatorcontrib><creatorcontrib>Carr, Matthew J.</creatorcontrib><creatorcontrib>Diaz, Joseph A.</creatorcontrib><creatorcontrib>Sise, C. Beth</creatorcontrib><creatorcontrib>Bansal, Vishal</creatorcontrib><creatorcontrib>Sise, Michael J.</creatorcontrib><creatorcontrib>Martin, Matthew J.</creatorcontrib><title>The rising tide of methamphetamine use in elderly trauma patients</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH’s impact in elderly trauma patients.
Retrospective analysis (2009–2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.
Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%–8%; p < 0.01). Elderly METH + patients were more likely to require surgical intervention (35% vs. 17%), mechanical ventilation (15% vs. 7%), and a longer hospitalization (6.5 vs. 3.6 days) compared with elderly substance negative. Multivariate analysis showed increasing age, ventilator use, and injury severity were associated with mortality (ps < 0.01); METH was not related to mortality.
Substance use in elderly trauma patients increased significantly. METH use in elderly trauma patients is a risk factor for significantly greater resource utilization.
•Substance abuse rates are increasing in elderly trauma patients, including METH.•METH use by elderly trauma patients is a risk for using more hospital resources.•Elderly trauma patients should be screened for substances to fully inform care.</description><subject>Alcohol</subject><subject>Assaults</subject><subject>Blood alcohol level</subject><subject>Chromatography</subject><subject>Drug screening</subject><subject>Drug use</subject><subject>Geriatric trauma</subject><subject>Geriatrics</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Impact analysis</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Intoxication</subject><subject>Length of stay</subject><subject>Marijuana</subject><subject>Mass spectrometry</subject><subject>Mechanical ventilation</subject><subject>Methamphetamine</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Older people</subject><subject>Patients</subject><subject>Resource utilization</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Scientific imaging</subject><subject>Statistical models</subject><subject>Substance use</subject><subject>Tetrahydrocannabinol</subject><subject>THC</subject><subject>Toxicology</subject><subject>Trauma</subject><subject>Trends</subject><subject>Urine</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1LxDAQhoMoun78BCXgxUvrJGnT9CQifoHgRc8hm07dlH6sSSr4743s6sGLlxkGnndmeAg5ZZAzYPKyy83Qhdm_5Rw4y4HnIGCHLJiq6owpJXbJAgB4VksGB-QwhC6NjBVinxwIUUEFChbk-mWF1LvgxjcaXYN0aumAcWWG9QqjGdyIdA5I3Uixb9D3nzR6Mw-Grk10OMZwTPZa0wc82fYj8np3-3LzkD093z_eXD9ltijrmMliaQSDmle2klW1FCiZaEuopVJSyHZpsEZVoLUtKw1YXpQK0ArJQaRixBG52Oxd--l9xhD14ILFvjcjTnPQvATGpZJKJPT8D9pNsx_Td4niteKyqIpElRvK-ikEj61eezcY_6kZ6G_HutNbx_rbsQauk-OUO9tun5cDNr-pH6kJuNoAmHR8OPQ62KTKYuM82qibyf1z4gtXHo3s</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Benham, Derek A.</creator><creator>Rooney, Alexandra S.</creator><creator>Calvo, Richard Y.</creator><creator>Carr, Matthew J.</creator><creator>Diaz, Joseph A.</creator><creator>Sise, C. 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Beth ; Bansal, Vishal ; Sise, Michael J. ; Martin, Matthew J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-64ba310927c7677b3e613f509688636fbae9e84eccf15a0c24580ec36203362a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Alcohol</topic><topic>Assaults</topic><topic>Blood alcohol level</topic><topic>Chromatography</topic><topic>Drug screening</topic><topic>Drug use</topic><topic>Geriatric trauma</topic><topic>Geriatrics</topic><topic>Health risks</topic><topic>Hospitals</topic><topic>Impact analysis</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Intoxication</topic><topic>Length of stay</topic><topic>Marijuana</topic><topic>Mass spectrometry</topic><topic>Mechanical ventilation</topic><topic>Methamphetamine</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Older people</topic><topic>Patients</topic><topic>Resource utilization</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Scientific imaging</topic><topic>Statistical models</topic><topic>Substance use</topic><topic>Tetrahydrocannabinol</topic><topic>THC</topic><topic>Toxicology</topic><topic>Trauma</topic><topic>Trends</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benham, Derek A.</creatorcontrib><creatorcontrib>Rooney, Alexandra S.</creatorcontrib><creatorcontrib>Calvo, Richard Y.</creatorcontrib><creatorcontrib>Carr, Matthew J.</creatorcontrib><creatorcontrib>Diaz, Joseph A.</creatorcontrib><creatorcontrib>Sise, C. 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Beth</au><au>Bansal, Vishal</au><au>Sise, Michael J.</au><au>Martin, Matthew J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The rising tide of methamphetamine use in elderly trauma patients</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>221</volume><issue>6</issue><spage>1246</spage><epage>1251</epage><pages>1246-1251</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH’s impact in elderly trauma patients.
Retrospective analysis (2009–2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.
Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%–8%; p < 0.01). Elderly METH + patients were more likely to require surgical intervention (35% vs. 17%), mechanical ventilation (15% vs. 7%), and a longer hospitalization (6.5 vs. 3.6 days) compared with elderly substance negative. Multivariate analysis showed increasing age, ventilator use, and injury severity were associated with mortality (ps < 0.01); METH was not related to mortality.
Substance use in elderly trauma patients increased significantly. METH use in elderly trauma patients is a risk factor for significantly greater resource utilization.
•Substance abuse rates are increasing in elderly trauma patients, including METH.•METH use by elderly trauma patients is a risk for using more hospital resources.•Elderly trauma patients should be screened for substances to fully inform care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33707080</pmid><doi>10.1016/j.amjsurg.2021.02.030</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-4701-8999</orcidid><orcidid>https://orcid.org/0000-0001-9147-2668</orcidid><orcidid>https://orcid.org/0000-0003-3362-0102</orcidid><orcidid>https://orcid.org/0000-0002-4792-9701</orcidid><orcidid>https://orcid.org/0000-0001-5832-783X</orcidid></addata></record> |
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| subjects | Alcohol Assaults Blood alcohol level Chromatography Drug screening Drug use Geriatric trauma Geriatrics Health risks Hospitals Impact analysis Injuries Injury analysis Intoxication Length of stay Marijuana Mass spectrometry Mechanical ventilation Methamphetamine Mortality Multivariate analysis Older people Patients Resource utilization Risk analysis Risk factors Scientific imaging Statistical models Substance use Tetrahydrocannabinol THC Toxicology Trauma Trends Urine |
| title | The rising tide of methamphetamine use in elderly trauma patients |
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