Pre-injury stimulant use in isolated severe traumatic brain injury: effect on outcomes.

Jakob, Dominik Andreas; Lewis, Meghan; Benjamin, Elizabeth Robinson; Haltmeier, Tobias; Schnüriger, Beat; Exadaktylos, Aristomenis Konstantinos; Demetriades, Demetrios (2023). Pre-injury stimulant use in isolated severe traumatic brain injury: effect on outcomes. European journal of trauma and emergency surgery, 49(4), pp. 1683-1691. Springer-Medizin-Verlag 10.1007/s00068-022-02095-7

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PURPOSE

The aim of this study was to assess the impact of pre-injury stimulant use (amphetamine, cocaine, methamphetamine and/or ecstasy) on outcomes after isolated severe traumatic brain injury (TBI).

METHODS

Retrospective 2017 TQIP study, including adult trauma patients (≥16 years old) who underwent drug and alcohol screening on admission and sustained an isolated severe TBI (head AIS ≥3). Patients with significant extracranial trauma (AIS ≥3) were excluded. Epidemiological and clinical characteristics, procedures and outcome variables were collected. Patients with isolated stimulant use were matched 1:1 for age, gender, mechanism of injury, head AIS and overall comorbidities, with patients with negative toxicology and alcohol screen. Outcomes in the two groups were compared with univariable and multivariable regression analysis.

RESULTS

681 patients with isolated TBI and stimulant use were matched with 681 patients with negative toxicology and alcohol screen. The incidence of hypotension and CGS <9 was similar in the two groups. In multivariable regression analysis, stimulant use was not independently associated with mortality (OR 0.95, 95% CI 0.61-1.49). However, stimulant use was associated with longer hospital length of stay (HLOS) (RC 1.13, 95%CI 1.03-1.24).

CONCLUSION

Pre-injury stimulant use is common in patients admitted for severe TBI, but was not independently associated with mortality when compared to patients with negative toxicology. However, stimulant use was associated with a significant longer HLOS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery

UniBE Contributor:

Jakob, Dominik, Haltmeier, Tobias, Schnüriger, Beat, Exadaktylos, Aristomenis

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1863-9933

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Pubmed Import

Date Deposited:

07 Sep 2022 09:21

Last Modified:

25 Aug 2023 00:11

Publisher DOI:

10.1007/s00068-022-02095-7

PubMed ID:

36066583

Uncontrolled Keywords:

Amphetamine Cocaine Ecstasy Head Methamphetamine Trauma

BORIS DOI:

10.48350/172709

URI:

https://boris.unibe.ch/id/eprint/172709

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