NYMC Faculty Publications

How Does Drug Abuse Affect Outcomes After Trauma? a Trauma Quality Improvement Program Study

Author Type(s)

Faculty

DOI

10.1016/j.amjsurg.2025.116332

Journal Title

American Journal of Surgery

Document Type

Article

Publication Date

6-1-2025

Department

Surgery

Keywords

Drug abuse, Quality improvement, Treatment outcome, Ventilator weaning

Disciplines

Medicine and Health Sciences

Abstract

Background: The protective effects of drug abuse on ICU admissions and ventilator weaning after trauma are debated. This study examines the impact of drug abuse on mortality, ICU admissions, and complications. Methods: Trauma patients ≥16 years from the TQIP database (2020–2022) with admission toxicology testing (TOX) were analyzed. The primary outcome was mortality; secondary outcomes included in-hospital complications. Results: Among 861,450 patients, decreased mortality odds were noted with cannabinoid (OR ​= ​0.842), amphetamine (OR ​= ​0.800), cocaine (OR ​= ​0.851), opioid (OR ​= ​0.625), and benzodiazepine (OR ​= ​0.843) (P ​< ​0.001). Reduced ICU admission odds were linked to opioid (OR ​= ​0.882), barbiturate (OR ​= ​0.824), oxycodone (OR ​= ​0.829), ecstasy (OR ​= ​0.811), and methadone (OR ​= ​0.809). Lower intubation odds were seen with opioid (OR ​= ​0.663), barbiturate (OR ​= ​0.733), oxycodone (OR ​= ​0.754), and ecstasy (OR ​= ​0.627). Methamphetamine (OR ​= ​0.682) was associated with reduced ARDS odds. Conclusions: Recreational drugs may independently reduce ICU admissions, intubation, and mortality, warranting further investigation. Level of evidence: Level III retrospective study.

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