[Incidence of the consumption of toxic substances in severe trauma patients]. / Incidencia del consumo de tóxicos en pacientes con traumatismos graves.

OBJECTIVE: To determine the incidence of the detection of abuse drugs in severe trauma patients DESIGN: Prospective observational study conducted from July 2004 to January 2006. SETTING: Neurotrauma intensive care unit of a reference tertiary university hospital. PATIENTS: Trauma patients who require admission to ICU during the study period. INTERVENTIONS: Determination of alcohol in blood and of toxics (cocaine, cannabis, amphetamines and other substances) in urine. RESULTS: Toxicological analysis was performed in 196 of the 288 severe trauma patients admitted during the study period. The most frequently detected cause of the trauma was traffic accident (69%). The most frequently detected substance was cannabis (22.4%), followed by alcohol (17.3%) and cocaine (12.8%). Cannabis was detected in 26.1% of under-45-yr-old patients versus 9.3% of older patients (p < 0.05), and cocaine in 16.3% vs. 0% in over-45-yr-olds (p < 0.001). Some substance of abuse was detected in 45% of under-45-yr-olds versus 23% of older patients (p < 0.05). CONCLUSION: The high proportion of positive results to toxic substances in severely traumatized patients suggests that the epidemiological environment for these patients is of great concern. These data may be of interest for the design of future prevention campaign.

Incidencia del consumo de tóxicos en pacientes con traumatismos graves / Incidence of the consumption of toxic substances in severe trauma patients

Objetivo. Determinar la incidencia de detecciónde drogas de abuso en pacientes con traumatismograve.Diseño. Estudio observacional prospectivo,rea lizado entre julio de 2004 y enero de 2006.Ámbito. Unidad de Cuidados Intensivos (UCI)neurotraumatológica de un hospital de tercer nivel.Pacientes. Pacientes con traumatismos queprecisaron el ingreso en la UCI durante el períodode estudio.Intervenciones. Análisis de alcoholemia y de tóxicos(cocaína, cannabis, anfetaminas y otras) enorina.Resultados. Se obtuvo una muestra para análisisde tóxicos en 196 pacientes de los 288 ingresadospor traumatismo grave. La causa más frecuentedel traumatismo fue el accidente detráfico, con un 69%. El tóxico más frecuentementeencontrado fue el cannabis (22,4%), seguidodel alcohol (17,3%) y la cocaína (12,8%). En menoresde 45 años, el cannabis fue detectado en el26,1% frente al 9,3% en mayores de 45 años (p < 0,05)y la cocaína en un 16,3% frente al 0% (p < 0,001).En menores de 45 años fue detectada la presenciade algún tóxico en el 45% frente al 23% en mayoresde 45 años (p < 0,05).Conclusión. La alta proporción de resultadospositivos a tóxicos en pacientes con traumatismosgraves sugiere que el ambiente epidemiológicoen que se mueven estos pacientes es muy preocupante. Estos datos deberían tener importancia para diseñar futuras campañas de prevención

Objective. To determine the incidence of thedetection of abuse drugs in severe trauma patientsDesign. Prospective observational study conductedfrom July 2004 to January 2006.Setting. Neurotrauma intensive care unit of areference tertiary university hospital.Patients. Trauma patients who require admissionto ICU during the study period.Interventions. Determination of alcohol in bloodand of toxics (cocaine, cannabis, amphetaminesand other substances) in urine.Results. Toxicological analysis was performedin 196 of the 288 severe trauma patients admittedduring the study period. The most frequently detectedcause of the trauma was traffic accident(69%). The most frequently detected substancewas cannabis (22.4%), followed by alcohol(17.3%) and cocaine (12.8%). Cannabis was detectedin 26.1% of under-45-yr-old patients versus9.3% of older patients (p < 0.05), and cocainein 16.3% vs. 0% in over-45-yr-olds (p < 0.001).Some substance of abuse was detected in 45% ofunder-45-yr-olds versus 23% of older patients (p< 0.05).Conclusion. The high proportion of positive resultsto toxic substances in severely traumatizedpatients suggests that the epidemiological environmentfor these patients is of great concern These data may be of interest for the design of future prevention campaign