Psychoactive substances and previous hospital admissions, triage and length of stay in rural injuries: a prospective observational study

• Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
• Main Authors: Thomas Wilson, Torben Wisborg, Vigdis Vindenes, Ragnhild Elèn Gjulem Jamt, Stig Tore Bogstrand
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Psychoactive substances; Injury severity; MAIS; Repeat admittance; Duration; Rural; Medical emergencies. Critical care. Intensive care. First aid; RC86-88.9; Arctic; Finnmark
• Online Access: https://doi.org/10.1186/s13049-023-01156-z; https://doaj.org/article/ec66cacb9e134414bc229bdd9fd115ad

Abstract Background Patients admitted to hospital after an injury are often found to have used psychoactive substances prior to the injury. The aim of this study was to investigate the associations between psychoactive substances (alcohol, psychoactive medicinal drugs and illicit drugs) and previous hospital admissions, triage and length of stay in the arctic Norwegian county of Finnmark. Methods Patients ≥ 18 years admitted due to injury to trauma hospitals in Finnmark from January 2015 to August 2016 were approached. Parameters regarding admittance and hospital stay were collected from 684 patients and blood was analysed for psychoactive substances. Using a prospective, observational design, time, triage, length of stay in hospital, use of intensive care unit (ICU), injury severity, Alcohol Use Disorder Identification Test—Consumption (AUDIT-C) and number of previous admittances were investigated by bivariable testing and logistical regression analysis. Results Of 943 patients approached, 81% consented and 684 were included in the study. During the weekend, 51.5% tested positive for any substance versus 27.1% Monday–Friday. No associations were identified between testing positive and either triage or injury severity for any substance group although triage level was lower in patients with AUDIT-C ≥ 5. Short length of stay was associated with alcohol use prior to injury [odds ratio (OR) 0.48 for staying > 12 h, confidence interval (CI) 0.25–0.90]. The OR for staying > 24 h in the ICU when positive for an illicit substance was 6.33 (CI 1.79–22.32) while negatively associated with an AUDIT-C ≥ 5 (OR 0.30, CI 0.10–0.92). Patients testing positive for a substance had more often previously been admitted with the strongest association for illicit drugs (OR 6.43 (CI 1.47–28.08), compared to patients in whom no substances were detected. Conclusions Triage level and injury severity were not associated with psychoactive substance use. Patients using alcohol are more often discharged early, but illicit substances ...