A longitudinal study of former trauma center patients: the association between toxicology status and subsequent injury mortality.
BACKGROUND
Despite the current emphasis on injury prevention, little has been done to incorporate alcohol intervention programs into the care of the injured patient. The purpose of this study was to determine whether patients admitted to a trauma center with positive toxicology findings (TOX+) have a higher subsequent injury mortality than those without such findings (TOX-).


METHODS
We followed a cohort of 27,399 trauma patients discharged alive between 1983 and 1995 to determine subsequent mortality. Death certificates were obtained to identify the cause of death.


RESULTS
TOX+ patients had an injury mortality rate approximately twice that of the TOX- group (1.9% vs. 1.0%, p < 0.001). Overall, 22.7% of the deaths were due to injury; the TOX+ rate was 34.7% versus 15.4% for the TOX-.


CONCLUSIONS
These data add strength to the premise that untreated substance abuse-related injury remains an untapped injury prevention opportunity.
Dischinger
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Charles McC. Mathias National Study Center for Trauma & EMS, Baltimore, Maryland 21201, USA. pdischin@som.umaryland.edu
Mitchell
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Kufera
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Soderstrom
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Lowenfels
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012042:Registries; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000401:mortality*