Long-term outcomes of psychoactive drug use in trauma patients: A multicenter patient-reported outcomes study.
Activities of Daily Living
/ psychology
Chronic Pain
/ diagnosis
Duration of Therapy
Female
Functional Status
Humans
Injury Severity Score
Long Term Adverse Effects
/ chemically induced
Male
Mental Health
/ statistics & numerical data
Middle Aged
Prognosis
Psychotropic Drugs
/ administration & dosage
Quality of Life
Social Interaction
/ drug effects
Toxicity Tests
/ methods
United States
/ epidemiology
Wounds and Injuries
/ complications
Journal
The journal of trauma and acute care surgery
ISSN: 2163-0763
Titre abrégé: J Trauma Acute Care Surg
Pays: United States
ID NLM: 101570622
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
pubmed:
3
12
2020
medline:
16
4
2021
entrez:
2
12
2020
Statut:
ppublish
Résumé
Psychoactive drug use (PDU) is reported in up to 40% of trauma patients and is associated with a higher rate of in-hospital complications. However, little is known about its long-term impact on trauma patients. We aimed to assess the long-term functional, mental, and psychosocial outcomes of PDU in trauma patients 6 to 12 months after injury. Trauma patients with moderate to severe injuries (Injury Severity Score, >9) who had a toxicology screen upon admission to one of three level 1 trauma centers were contacted by phone 6 to 12 months postinjury. Psychoactive drug use was defined as the presence of a psychoactive, nonprescribed substance on toxicology screen including amphetamine, barbiturate, benzodiazepine, cannabinoid, methamphetamine, methadone, opioid, oxycodone, methylenedioxymethamphetamine (ecstasy), phencyclidine, tricyclic antidepressant, and cocaine. The interviews systematically evaluated functional limitations, social functioning, chronic pain, and mental health (posttraumatic stress disorder, depression, anxiety). Patients with a score of ≤47 on the Short-Form Health Survey version 2.0 social functioning subdomain were considered to have social dysfunction. Multivariable regression models were built to determine the independent association between PDU and long-term outcomes. Of the 1,699 eligible patients, 571 (34%) were included in the analysis, and 173 (30.3%) screened positive for PDU on admission. Patients with PDU were younger (median age [interquartile range], 43 [28-55] years vs. 66 [46-78] years, p < 0.001), had more penetrating injuries (8.7% vs. 4.3%, p = 0.036), and were less likely to have received a college education (41.3% vs. 54.5%, p = 0.004). After adjusting for patients' characteristics including the presence of a baseline psychiatric comorbidity, patients with PDU on admission were more likely to suffer from daily chronic pain, mental health disorders, and social dysfunction 6 to 12 months after injury. There was no difference in the functional limitations between patients with and without PDU. On the long term, PDU in trauma patients is strongly and independently associated with worse mental health, more chronic pain, and severe impairment in social functioning. A trauma hospitalization presents an opportunity to identify patients at risk and to mitigate the long-term impact of PDU on recovery. Prognostic/epidemiologic, level III.
Identifiants
pubmed: 33264267
pii: 01586154-202102000-00015
doi: 10.1097/TA.0000000000003032
doi:
Substances chimiques
Psychotropic Drugs
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
319-324Informations de copyright
Copyright © 2021 American Association for the Surgery of Trauma.
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