Toll of methamphetamine on the trauma system.
OBJECTIVE
Methamphetamine use affects length of hospital stay in the minimally injured patient.


METHODS
Case series.


METHODS
The only tertiary trauma center serving Hawaii.


METHODS
Trauma patients examined during a 12-month period with an Injury Severity Score of 1 to 5 and an age of 18 to 55 years undergoing urine toxicology screen for suspected suicide attempt or altered sensorium.


METHODS
Presence or absence of amphetamine or methamphetamine on urine toxicology screen, intention of injury, hospital admission rate, length of stay, and hospital charges.


RESULTS
During the study period, 1650 trauma patients were examined, with 544 meeting study criteria. Urine toxicology screens were performed in 212 patients, with 57 positive and 155 negative for amphetamine or methamphetamine. There was no difference in sex (77% vs 73% male; P =.53), Injury Severity Score (3.2 for both groups), or total number of computed tomographic scans performed (mean +/- SEM, 3.0 +/- 0.3 vs 4.0 +/- 0.3; P =.07). Patients in the positive group were more likely to have intentional self-inflicted injury or intentional assaults than patients in the negative group (37% vs 22%; P =.04). The positive group was older than the negative group (33.6 +/- 1.3 vs 29.9 +/- 0.8 years; P =.02), had a significantly longer hospital stay (2.7 +/- 0.4 vs 1.7 +/- 0.1 days; P =.003), had significantly higher hospital charges (15 617 dollars +/- 1866 dollars vs 11 600 dollars +/- 648 dollars; P =.01), and was more likely admitted to the hospital (91% vs 70%; P =.001) despite the low Injury Severity Score.


CONCLUSIONS
Methamphetamine use results in trauma center resource utilization out of proportion to injury severity.
Department of Surgery, The Queen's Medical Center, John A. Burns School of Medicine, University of Hawaii, Honolulu, USA. gtominaga@queens.org
Gail T
GT
Tominaga
George
G
Garcia
Alex
A
Dzierba
Jan
J
Wong
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity* / Q000652:urine; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008694:Methamphetamine / Q000633:toxicity* / Q000652:urine; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications / Q000652:urine*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications
D013287:Illicit Drugs; D008694:Methamphetamine