title: The scourge of methamphetamine: impact on a level I trauma center.
abstract: BACKGROUND
  Methamphetamine (METH) use is associated with high-risk behavior and serious injury. The aim of this study was to assess the impact of METH use in trauma patients on a Level I trauma center to guide prevention efforts.
  
  
  METHODS
  A retrospective registry-based review of 4,932 consecutive trauma patients who underwent toxicology screening at our center during a 3-year period (2003-2005). This sample represented 76% of all trauma patients seen during this interval.
  
  
  RESULTS
  From the first half of 2003 to the second half of 2005, overall use of METH increased 70% (p < 0.001), surpassing marijuana as the most common illicit drug used by the trauma population. Other illicit drug use did not significantly change during this interval. METH-positive patients were more likely to have a violent mechanism of injury (47.3% vs. 26.3%, p < 0.001), with 33% more assaults (p < 0.01), 96% more gunshot wounds (p < 0.001), and 158% more stab wounds (p < 0.001). They were more likely to have attempted suicide (4.8% vs. 2.6%, p < 0.01), to have had an altercation with law enforcement (1.8% vs. 0.3%, p < 0.001), or been the victim of domestic violence (4.4% vs. 2.1%, p < 0.001). METH users had a higher mean Injury Severity Score (11.2 vs. 10.0, p < 0.01), were 62% more likely to receive mechanical ventilation (p < 0.001), and 53% more likely to undergo an operation (p < 0.001). They were more prone to leave against medical advice (4.9% vs. 2.1%, p < 0.001) and 113% more likely to die from their injuries (6.4% vs. 3.0%, p < 0.001). The average cost of care per METH user was 9% higher than that for nonusers, and METH users were more likely to be unfunded than nonusers (47.6% vs. 23.1%, p < 0.001). The annual uncompensated cost of care of METH users increased 70% during the study period to $1,477,108 in 2005.
  
  
  CONCLUSIONS
  METH use in trauma patients increased significantly and was associated with adverse outcomes and a significant financial burden on our trauma center. Evidence-based prevention efforts must be a priority for trauma centers to help stop the scourge of METH.
authors: Division of Trauma, Scripps Mercy Hospital, San Diego, California, USA.
authors: Sophia M
authors: SM
authors: Swanson
authors: C Beth
authors: CB
authors: Sise
authors: Michael J
authors: MJ
authors: Sise
authors: Daniel I
authors: DI
authors: Sack
authors: Troy Lisa
authors: TL
authors: Holbrook
authors: Gabrielle M
authors: GM
authors: Paci
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity* / Q000652:urine; D008297:Male; D008694:Methamphetamine / Q000633:toxicity* / Q000652:urine; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000652:urine*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications
chemical_list: D013287:Illicit Drugs; D008694:Methamphetamine