The impact of methamphetamines in patients with traumatic brain injury, a retrospective review

Clin Neurol Neurosurg. 2018 Jul:170:99-101. doi: 10.1016/j.clineuro.2018.04.030. Epub 2018 Apr 27.

Abstract

Objective: Both neurotoxic and neuroprotective effects of methamphetamines (METH) are being studied. There are few studies evaluating the effects of METH on patients with traumatic brain injury (TBI). The objective of this study is to compare clinical outcomes after TBI in METH users versus non-METH users.

Patient and methods: A retrospective review of 304 patients with severe traumatic head injury were performed. Patients were evaluated and stratified based on toxicology screening for methamphetamines (METH) or none. Of the patients reviewed with a full toxicology, 24 of those patients were positive for METH, and 60 patients were negative. Patients were evaluated based on demographics, type of injury, Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS).

Results: METH patients were younger upon presentation (43.5 versus 55.8, p = 0.003), with a larger improvement in GCS and GOS upon discharge (P = 0.012, 0.0001 respectively). There was no significant difference in length of hospital stay, initial presenting GCS and GOS, or discharge GCS and GOS.

Conclusions: Our findings demonstrate an improved change in GCS and GOS for those positive with METH than those without. Surprisingly, substance positive patients did not have a worse outcome score. Further investigation is necessary to evaluate the potential neuro-protective effects of METH in TBI.

Keywords: Amphetamines; Methamphetamines; TBI; Traumatic brain injury.

MeSH terms

  • Adult
  • Aged
  • Brain Injuries, Traumatic / blood*
  • Brain Injuries, Traumatic / diagnosis
  • Brain Injuries, Traumatic / prevention & control*
  • Central Nervous System Stimulants / administration & dosage
  • Central Nervous System Stimulants / blood*
  • Cohort Studies
  • Female
  • Glasgow Outcome Scale / trends
  • Humans
  • Length of Stay / trends
  • Male
  • Methamphetamine / administration & dosage
  • Methamphetamine / blood*
  • Middle Aged
  • Retrospective Studies
  • Substance Abuse Detection / trends

Substances

  • Central Nervous System Stimulants
  • Methamphetamine