title: The Effect of Illicit Drug Use on Outcomes Following Burn Injury.
abstract: Illicit drug use is common among patients admitted following burn injury. The authors sought to evaluate whether drug abuse results in worse outcomes. The National Burn Repository (NBR) was queried for data on all patients with drug testing results available. Outcomes included mortality, hospital length of stay (LOS), intensive care unit (ICU) LOS, and duration of ventilator support. Propensity score weighting was performed to control for age, alcohol use, burn size, gender, and etiology of burn. A total of 20,989 patients had drug screen data available; 11,642 (55.5%) tested positive for at least one drug of abuse. Illicit drug use was associated with a higher proportion of patients with flame burn (53.2 vs 48.4%) and larger average burn size (11.2 vs 9.5% TBSA, P < .001). Attempted suicide was more likely if the patient had used drugs (2.8 vs 1.7%, P < .001). Drug use resulted in longer hospital and ICU LOS (14.2 vs 11.4 and 8.5 vs 5.6 days, P < .001), but did not increase the risk of mortality (5.7 vs 5.2, P = .08). After propensity score weighting, drug use did not affect mortality, hospital LOS, or duration of ventilator support, but did increase the average ICU LOS by 1.2 days (P = .001). Drug use does not affect mortality, hospital LOS, or duration of ventilator support among burned patients. After controlling for burn size, age, mechanism of injury, and gender, patients with a positive drug screen had an average increase in ICU LOS by 1 day.
authors.affiliation: From the Division of Burns, Trauma, and Critical Care, Department of General Surgery, University of Texas, Southwestern Dallas.
authors.forename: Erica I
authors.initials: EI
authors.lastname: Hodgman
authors.forename: Madhu
authors.initials: M
authors.lastname: Subramanian
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wolf
authors.forename: Brett D
authors.initials: BD
authors.lastname: Arnoldo
authors.forename: Herb A
authors.initials: HA
authors.lastname: Phelan
authors.forename: Michael W
authors.initials: MW
authors.lastname: Cripps
authors.forename: Kareem R
authors.initials: KR
authors.lastname: Abdel Fattah
mesh_terms: D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D002053:Burn Units / Q000706:statistics & numerical data; D002056:Burns / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D015813:Substance Abuse Detection / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States
chemical_list: D013287:Illicit Drugs