title: Urine toxicology screening in Austrian trauma patients: a prospective study.
abstract: BACKGROUND
  The question as to whether the patient consumed drugs prior to the trauma and which drugs were consumed, is of prime importance for the anesthesia required during surgery. However, many patients are unwilling or unable (including those with multiple trauma or impaired consciousness, or unconscious patients) to answer this question. The purpose of our prospective multicenter study was to collect data about drug consumption in Austria to determine whether drugs are identifiable in the urine of recently injured individuals and to establish the types of drugs consumed.
  
  
  METHODS
  This prospective study included severely and moderately injured patients admitted to the Lorenz Boehler Trauma Hospital (Vienna, Austria), the Trauma Hospital Linz (Linz, Austria) and the Department of Trauma Surgery of the General Hospital Horn (Horn, Austria) during an 18-month period (October 2003-March 2005). All patients were suffering from injuries urgently requiring surgery. Urine samples were gained from all patients immediately after admission. Urinary samples were tested by Immuno-Assay (Triage 8 Immuno-Assay, Biosite, San Diego, USA). Urine samples were screened simultaneously for opiates, methadone, cocaine, barbiturates, amphetamines, cannabinoids, benzodiazepines and tricyclic antidepressants.
  
  
  RESULTS
  Our prospective study included a total of 664 patients (320 from Vienna, 193 from the city of Linz, and 151 from Horn). Six hundred and forty-two patients were moderately injured (ISS < 16), suffering mostly from injuries to the extremities (504 patients) and 22 patients were severely injured (ISS > 16). Of the 664 patients, 178 (26.8%) tested positive for one or more drugs. The drugs most commonly detected were benzodiazepines (111 patients, 16.7%), cannabinoides (39 patients, 6%), tricyclic antidepressants (28, 4.2%) and opiates (26, 3.9%).
  
  
  CONCLUSIONS
  Drug use is widespread in patients presenting to urban trauma centers in Austria. Physicians should maintain a high index of suspicion that their patients may be intoxicated and should perform drug testing routinely.
authors.affiliation: Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Trauma Research Center of the Austrian Workers' Compensation Board, Vienna, Austria. m.figl@gmx.at
authors.forename: Markus
authors.initials: M
authors.lastname: Figl
authors.forename: Linda E
authors.initials: LE
authors.lastname: Pelinka
authors.forename: Patrick
authors.initials: P
authors.lastname: Weninger
authors.forename: Christoph
authors.initials: C
authors.lastname: Walchetseder
authors.forename: Walter
authors.initials: W
authors.lastname: Mauritz
authors.forename: Harald
authors.initials: H
authors.lastname: Hertz
authors.forename: Albert
authors.initials: A
authors.lastname: Kroepfl
authors.forename: Robert
authors.initials: R
authors.lastname: Schmidhammer
authors.forename: Walter
authors.initials: W
authors.lastname: Buchinger
authors.forename: Heinz
authors.initials: H
authors.lastname: Redl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000652:urine*; D014947:Wounds and Injuries / Q000652:urine*; D055815:Young Adult