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Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010.

Publication ,  Journal Article
Beasley, GM; Ostbye, T; Muhlbaier, LH; Foley, C; Scarborough, J; Turley, RS; Shapiro, ML
Published in: J Surg Res
May 1, 2014

BACKGROUND: Although the relationship between psychoactive substance use and injury is known, evidence remains conflicting on the impact of substance use on clinical outcomes after injury. We hypothesized that preinjury substance use would negatively impact clinical outcomes. METHODS: National Trauma Registry American College of Surgeons identified patients (n = 9793) presenting to Duke Hospital from 2006 to 2010. Logistic regression models assessed potential predictors of receiving substance screening, mortality, length of stay, ventilator requirement, intensive care admission, or emergency department disposition. RESULTS: Forty-seven percent (4607/9793) of patients received blood alcohol screen (BAS) and 31% (3017/9793) received urine drug screen (UDS). Men were more likely to receive both BASs (P < 0.001) and UDSs (P = 0.001) than women after controlling for potential confounders. There was no significant difference between men and women over the legal limit for alcohol (OLLA; 27.2%, 95% confidence interval [CI]: 25.7%-28.8% versus 24.8%, 95% CI: 22.3%-27.5%). Similarly, younger patients more likely received both BASs (P < 0.001) and UDSs (P < 0.001) compared with older patients. The proportion of patients aged ≤45 y OLLA (26.5 %, 95% CI: 24.9%-28.2%) was similar to those aged >45 y OLLA (26.8%, 95% CI: 24.5%-29.3%). After controlling for potential confounders neither alcohol, nor tetrahydrocannabinol, nor cocaine was predictive of mortality, ventilator requirement, length of stay, or emergency department disposition, but a higher alcohol level (P = 0.0174) predicted intensive care admission. CONCLUSIONS: Females and those aged >45 y are less likely to receive BASs and UDSs. Differential screening that is biased may place patients at risk for receiving inadequate care.

Duke Scholars

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

May 1, 2014

Volume

188

Issue

1

Start / End Page

190 / 197

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Trauma Centers
  • Surgery
  • Substance-Related Disorders
  • Substance Abuse Detection
  • Sex Factors
  • Registries
  • Middle Aged
  • Male
  • Length of Stay
 

Citation

APA
Chicago
ICMJE
MLA
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Beasley, G. M., Ostbye, T., Muhlbaier, L. H., Foley, C., Scarborough, J., Turley, R. S., & Shapiro, M. L. (2014). Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010. J Surg Res, 188(1), 190–197. https://doi.org/10.1016/j.jss.2013.11.1103
Beasley, Georgia M., Truls Ostbye, Lawrence H. Muhlbaier, Carolyn Foley, John Scarborough, Ryan S. Turley, and Mark L. Shapiro. “Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010.J Surg Res 188, no. 1 (May 1, 2014): 190–97. https://doi.org/10.1016/j.jss.2013.11.1103.
Beasley GM, Ostbye T, Muhlbaier LH, Foley C, Scarborough J, Turley RS, et al. Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010. J Surg Res. 2014 May 1;188(1):190–7.
Beasley, Georgia M., et al. “Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010.J Surg Res, vol. 188, no. 1, May 2014, pp. 190–97. Pubmed, doi:10.1016/j.jss.2013.11.1103.
Beasley GM, Ostbye T, Muhlbaier LH, Foley C, Scarborough J, Turley RS, Shapiro ML. Age and gender differences in substance screening may underestimate injury severity: a study of 9793 patients at level 1 trauma center from 2006 to 2010. J Surg Res. 2014 May 1;188(1):190–197.
Journal cover image

Published In

J Surg Res

DOI

EISSN

1095-8673

Publication Date

May 1, 2014

Volume

188

Issue

1

Start / End Page

190 / 197

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Trauma Centers
  • Surgery
  • Substance-Related Disorders
  • Substance Abuse Detection
  • Sex Factors
  • Registries
  • Middle Aged
  • Male
  • Length of Stay