title: Cocaine-related medical and trauma problems: a consecutive series of 743 patients from a multicentre study in Italy.
abstract: OBJECTIVE
  The purpose of this retrospective study was to describe the spectrum of medical and trauma complications associated with self-reported cocaine use.
  
  
  METHODS
  Patient databases of 23 emergency departments were searched for consultations related to cocaine use between January 2007 and December 2008.
  
  
  RESULTS
  The population included 569 men (84.4%) and 105 women (15.6%): 505 (74.9%) patients were nondependent cocaine users and 169 (25.1%) were dependent cocaine users. The majority of patients (63.8%) used other drugs in combination with cocaine. Psychiatric symptoms were most frequently reported (60.9%), followed by cardiopulmonary (38.2%), gastrointestinal (22.5%), neurological (20.8%) and constitutional (17.2%) symptoms. Of psychiatric complaints, anxiety was the most common (31.5%). Sex-adjusted and age-adjusted odds ratio (OR) showed that palpitations were associated within 12 h of cocaine use [OR 2.05; 95% confidence interval (CI): 1.12-3.76], and psychotic symptoms (OR 3.05; 95% CI: 1.02-9.18) and hallucinations (OR 7.50; 95% CI: 1.12-50.31) were associated within more than 12 h of the use of cocaine. In a comparison of dependent and nondependent cocaine users, after adjusting for age and sex, cardiopulmonary symptoms (OR 1.56; 95% CI: 1.08-2.24) and paranoia (OR 2.14; 95% CI: 1.08-4.24) were associated with nondependent use of cocaine, and lethargy (OR 7.14; 95% CI: 1.55-35.56) was associated with dependent use of cocaine. The primary cause of trauma was unintentional injuries (32.4%). Sex-adjusted and age-adjusted OR showed a major risk for unintentional injuries with nondependent use of cocaine (OR 6.17; 95% CI: 1.38-42.29).
  
  
  CONCLUSIONS
  The study shows that cocaine users experience diverse symptoms and may present with a wide range of physical findings.
authors.affiliation: Epidemiological Monitoring Center on Addiction, DSM-DP, Ospedale Maggiore C.A. Pizzardi, Ausl Bologna, Italy.
authors.forename: Raimondo
authors.initials: R
authors.lastname: Pavarin
authors.forename: Fabio
authors.initials: F
authors.lastname: Lugoboni
authors.forename: Sophie
authors.initials: S
authors.lastname: Mathewson
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ferrari
authors.forename: Giordano
authors.initials: G
authors.lastname: Guizzardi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Quaglio
mesh_terms: D000293:Adolescent; D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D004630:Emergencies; D005260:Female; D006753:Hospital Records; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult