The impact of substance abuse on mortality in patients with severe traumatic brain injury

Kristine H O'Phelan, David L. McArthur, Cherylee W J Chang, Deborah Green, David A. Hovda

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Background:: Drug and alcohol use are common in neurotrauma patients. Despite growing methamphetamine use there are few studies of the impact of methamphetamine use on outcome after traumatic brain injury (TBI). Methods:: We conducted a retrospective review of 5-years of data from a trauma database. Inclusion criteria included severe TBI and diagnosis codes indicating head injury. The entire database was analyzed and then a subset of patients with complete toxicology data were examined separately. Primary outcome was mortality. Results:: Four hundred eighty-three patients were included. Toxicology results were available for 52.6% of patients. Alcohol, amphetamines, and cannabis were the most commonly detected substances. Overall mortality was 50.9%. When the group with complete tox screen data were analyzed, a toxicology screen that was positive for alcohol or amphetamine was associated with decreased mortality with an odds ratio of 0.23 (CI: 0.10-0.56, p = 0.001) and 0.25 (CI: 0.08-0.79, p = 0.02), respectively. When the subset of patients for whom toxicology data were available was analyzed the amphetamine-positive group was more likely to use cannabis and less likely to use alcohol. Conclusions:: We unexpectedly found alcohol and methamphetamine use to be associated with decreased mortality. Neurotoxic and possible neuroprotective mechanisms of these substances are discussed as well as possible interactions between cannabis and methamphetamine. The potential influence of psycho-social factors are also considered. Prospective studies are needed to further investigate the effects of drug and alcohol use on outcome after severe TBI.

Original languageEnglish
Pages (from-to)674-677
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume65
Issue number3
DOIs
StatePublished - Sep 1 2008
Externally publishedYes

Fingerprint

Substance-Related Disorders
Methamphetamine
Alcohols
Toxicology
Mortality
Cannabis
Amphetamine
Databases
Amphetamines
Craniocerebral Trauma
Pharmaceutical Preparations
Traumatic Brain Injury
Odds Ratio
Prospective Studies
Wounds and Injuries

Keywords

  • Alcohol
  • Methamphetamine
  • Outcome
  • Traumatic brain injury

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

The impact of substance abuse on mortality in patients with severe traumatic brain injury. / O'Phelan, Kristine H; McArthur, David L.; Chang, Cherylee W J; Green, Deborah; Hovda, David A.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 65, No. 3, 01.09.2008, p. 674-677.

Research output: Contribution to journalArticle

O'Phelan, Kristine H ; McArthur, David L. ; Chang, Cherylee W J ; Green, Deborah ; Hovda, David A. / The impact of substance abuse on mortality in patients with severe traumatic brain injury. In: Journal of Trauma - Injury, Infection and Critical Care. 2008 ; Vol. 65, No. 3. pp. 674-677.
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