Drug and alcohol use among adolescent blunt trauma patients: dying to get high?

Purpose: We compared injury severity, hospital course, and outcomes between adolescent blunt trauma patients with and without positive toxicology screens. Methods: Trauma registry data were used to identify adolescent blunt trauma victims between 2000 and 2005. Demographics, injury severity, hospital course, and outcomes were evaluated. Patients with and without positive toxicology results were compared. Results: There were 9.3% that had positive toxicology results. The mean age of toxicology-positive patients was 17.2 years. The most commonly detected drugs were cannabinoids (40%), alcohol (30%), and polysubstances (23%). Toxicology-positive patients had significantly lower Glasgow Coma Scale (11.8 ± 4.6 vs 13.7 ± 3.3; P < .001), higher Injury Severity Score (16.7 ± 11.2 vs 10.4 ± 9.1; P < .001), and required more emergent operations (20.7% vs 12.8%; P < .001). Length of stay was longer (7.3 ± 8.1 vs 4.8 ± 7.2 days; P < .001). Functional Independence Measure scores were lower (10.5 ± 2.2 vs 11.2 ± 1.7; P < .001); mortality was higher (6.4% vs 2.6%; P < .001). Conclusions: A significant number of adolescents had positive toxicology screens. Our data suggest that toxicology-positive patients were more severely injured, required more hospital care, and had worse outcomes than other adolescent blunt trauma victims.