The rising tide of methamphetamine use in elderly trauma patients

Am J Surg. 2021 Jun;221(6):1246-1251. doi: 10.1016/j.amjsurg.2021.02.030. Epub 2021 Mar 6.

Abstract

Background: Methamphetamine (METH) is associated with an elevated risk of injury and the outcomes in the elderly remain unclear. We analyzed METH's impact in elderly trauma patients.

Methods: Retrospective analysis (2009-2018) of trauma patients at a Level I trauma center. Elderly patients were defined as age ≥55. Substance use was identified by blood alcohol test and urine drug screen. Cox proportional hazard model was used to assess patient and injury characteristics with mortality.

Results: Of 15,770 patient encounters with substance use testing, 5278 (34%) were elderly. Elderly METH use quadrupled over time (2%-8%; p < 0.01). Elderly METH + patients were more likely to require surgical intervention (35% vs. 17%), mechanical ventilation (15% vs. 7%), and a longer hospitalization (6.5 vs. 3.6 days) compared with elderly substance negative. Multivariate analysis showed increasing age, ventilator use, and injury severity were associated with mortality (ps < 0.01); METH was not related to mortality.

Conclusion: Substance use in elderly trauma patients increased significantly. METH use in elderly trauma patients is a risk factor for significantly greater resource utilization.

Keywords: Blood alcohol level; Geriatric trauma; Intoxication; Methamphetamine; Substance use.

MeSH terms

  • Age Factors
  • Aged
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Amphetamine-Related Disorders / complications*
  • Amphetamine-Related Disorders / epidemiology
  • California / epidemiology
  • Female
  • Humans
  • Injury Severity Score
  • Length of Stay
  • Male
  • Methamphetamine / adverse effects*
  • Methamphetamine / therapeutic use
  • Middle Aged
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Substance Abuse Detection
  • Trauma Centers / statistics & numerical data
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / etiology*

Substances

  • Methamphetamine