Trauma patients who test positive for methamphetamine are more likely to be admitted to the hospital

Trauma patients who test positive for methamphetamine are more likely to be admitted to the hospital and have significantly higher hospital costs, according to an article in the August issue of the Archives of Surgery, one of the JAMA/Archives journals.

Methamphetamine use is a major health care problem in the United States, and rates of use appear highest in Hawaii, with 40 percent of people arrested in Honolulu testing positive for methamphetamine, according to the article. Methamphetamine can cause aggressive and erratic behavior, and severe exhaustion can result after a "high", which can last 6 to 12 hours or more.

Gail T. Tominaga, M.D., of The Queen's Medical Center, Honolulu, and colleagues investigated whether the use of methamphetamine affects hospital length of stay (LOS) in minimally injured trauma patients.

The researchers studied the records of 212 patients (aged 18 to 55 years) admitted to a trauma center between January 1, 2002 and December 31, 2002 who were injured and for whom toxicology screenings were performed to evaluate the patients for suspected suicide attempt or altered level of consciousness (i.e., decreased alertness).

Of the 212 patients, 57 tested positive for amphetamine or methamphetamine use. Patients who tested positive were more likely to have an intentional self-inflicted injury or intentional assaults than patients who tested negative (37 percent vs. 22 percent). Patients who tested positive were older (average age, 33.6 years vs. 29.9 years), were more likely to be admitted to the hospital (91 percent vs. 70 percent), had longer hospital stays (average LOS, 2.7 days vs. 1.7 days), and had significantly higher hospital charges (average cost, $15,617 vs. $11,600).

"Our study demonstrated an increased use of hospital resources, measured by hospital LOS and charges, in the minimally injured adult trauma patients who tested positive for methamphetamine," the authors write. "This can be explained by the physiological and psychological effects of the drug."

http://archsurg.ama-assn.org