Cannabis appears in regional trauma cases, but outcomes are mixed

Trauma Under the Influence: A Cross-Sectional Registry Audit of Drug and Alcohol-Related Major Trauma in North Queensland.

Emergency medicine Australasia : EMA β€’ β€’ Moderately Relevant
πŸ€–

AI Summary

This retrospective audit examined 319 major trauma patients treated at Townsville University Hospital in North Queensland between October 2022 and October 2023. Alcohol and drug use was identified in 110 patients (34.4%). Alcohol was the most commonly detected substance, while cannabis was detected in 20.0% of the alcohol-and-drug cohort; amphetamines were also identified, and 18.2% showed polysubstance use.

Patients who tested positive for alcohol and/or drugs were younger on average and were much more likely to have injuries related to assault. However, the study found no significant differences between the groups in ICU admission, ICU length of stay, hospital length of stay, discharge, or mortality. Because screening practices were inconsistent, the authors caution that the true prevalence of substance involvement is uncertain. Standardised testing, prevention efforts, and tailored trauma-care pathways may help address the burden of substance-related injury, although the study does not establish that cannabis itself caused the injuries or affected clinical outcomes.

πŸ’‘ Key Findings

1
Cannabis was detected in 20.0% of patients in the alcohol-and-drug cohort, although alcohol was detected more often.
Good
70%
2
Patients positive for alcohol and/or drugs were significantly younger and more likely to sustain assault-related injuries than other major trauma patients.
High
80%
3
The study found no significant differences between groups in ICU admission, ICU or hospital length of stay, discharge, or mortality.
High
80%
4
Because screening was inconsistent, the true prevalence of alcohol- and drug-related trauma remains uncertain, supporting the need for standardised testing and further research.
High
85%

πŸ“„ Original Abstract

Alcohol and drug use is an established factor contributing to traumatic injury globally, yet regional and remote prevalence and impact are poorly characterised. This study examines associations between alcohol and drug use and clinical outcomes among major trauma patients in North Queensland. A retrospective audit of major trauma patients in Townsville University Hospital Trauma Registry between October 2022-2023. Patients were classified by alcohol and drug use based on toxicology results and electronic medical record. Demographic, injury and outcome variables were compared using descriptive and non-parametric analysis. Of 319 eligible patients, 110 (34.4%) patients were identified within the alcohol and drug cohort. Alcohol was most frequently detected (82.7%), followed by cannabis (20.0%) and amphetamines (12.7%), with 18.2% demonstrating polysubstance use. Alcohol and/or drug-positive patients were significantly younger (40.7 vs. 49.0&#x2009;years, p&#x2009;=&#x2009;0.002) and more likely to sustain assault-related injuries (OR 6.9 (95% CI: 3.1-15.3), p&#x2009;<&#x2009;0.001). No statistical significance was found between groups for ICU admission rate, ICU LOS or hospital LOS. Discharge and mortality outcomes did not differ between groups. This study highlights the impact of alcohol and drug use in regional major trauma patients. Standardised testing, targeted prevention and tailored clinical pathways may improve outcomes and reduce the burden of alcohol and drug-related trauma. Inconsistent screening practices mean the true prevalence remains uncertain, warranting further research to determine the impact and guide interventions.

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