Journal of Emergencies, Trauma, and Shock
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
Users online:2206   Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size   
Year : 2020  |  Volume : 13  |  Issue : 4  |  Page : 279-285

The effect of illegal drug screening results and chronic drug use on perioperative complications in trauma

1 Department of Surgery, Saint Louis University, Saint Louis, Missouri, USA
2 Department of Trauma, Saint Louis University, Saint Louis, Missouri, USA

Correspondence Address:
Dr. John T Culhane
Department of Surgery, Saint Louis University, 3635 Vista Ave., Saint Louis, Missouri 63110-2539
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_141_19

Rights and Permissions

Context: Illegal drug use and need for surgery are common in trauma. This allows examination of the effects of perioperative drug use. Aim: The aim was to study the effects of illegal drug use on perioperative complications in trauma. Setting and Design: Propensity-matched analysis of perioperative complications between drug screen-positive (DSP) and drug screen-negative (DSN) patients from the National Trauma Data Bank (NTDB). Methods: The NTDB reports drug screening as a composite. We compared complications for DSP, DSN, and specific chronic drug disorders. Time to first procedure was analyzed to determine whether delay to surgery was associated with reduced complications. Statistics: Logistic regression with 11 predictor variables was used to calculate propensity scores. Categorical and continuous variables were compared using Chi-square and Student’s t-test, respectively. Results: 752,343 patients (21.9%) were tested for illegal drugs. DSP was protective for mortality-relative risk (RR) 0.84 (P < 0.001) and arrhythmia RR 0.87 (P = 0.02). All complications (AC) were higher for DSP with a RR of 1.08 (P < 0.001). Cocaine, cannabis, and opioids were associated with reduced mortality. Cocaine was associated with increased myocardial infarction (MI). All four chronic drug disorders were associated with markedly higher arrhythmia. All except cannabis were associated with higher AC. Mortality was significantly lower for DSP for every time interval until first procedure. Continuous-time until procedure was associated with increased MI and arrhythmia. Conclusions: DSP was protective of mortality and cardiac complications. Drug disorders were protective for mortality but increased arrhythmia and AC. Delay until the surgery does not diminish cardiac or overall risk.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded70    
    Comments [Add]    
    Cited by others 1    

Recommend this journal