Consumo de cocaína y su relación con patología cardiaca y traumática atendida en un servicio de urgencias / Cocaine use and its relationship with cardiovascular pathology and trauma seen in an emergency department

Objetivo: Conocer la prevalencia de consumo de cocaína entre usuarios que consultan a un servicio de urgencias de un hospital de tercer nivel por patología traumática o cardiovascular, sin que exista una relación evidente de consumo y sin que el usuario hiciera explícito de manera espontánea dicho consumo, así como si dicho consumo se asocia a una mayor utilización de recursos sanitarios. Método: Entre octubre de 2005 y septiembre de 2006 se recogieron muestras de orina a los pacientes mayores de 16 años que acudieron a urgencias por un traumatismo de cualquier gravedad o un dolor torácico de probable causa cardiovascular. Se determinaron los niveles de cocaína en orina mediante ensayos semicuantitativos con tecnología de inmunoanálisis de polarización de la fluorescencia (FPIA).Resultados: Se obtuvieron 325 casos (206 traumatismos y 119 dolores torácicos). La prevalencia global de consumo no declarado de cocaína fue del 19,7% (18,9% para los traumatismos y 21% para el dolor torácico). En los traumatismos, la presencia de cocaína se asoció de forma significativa a una mayor petición de analítica (p < 0,05), en tanto que en el dolor torácico no se observaron diferencias en el consumo de recursos. Conclusiones: El consumo de cocaína no declarado entre los usuarios de un servicio de urgencias con patología cardiológica o traumática presenta una prevalencia alta. No parece que este hecho modifique en gran medida el gasto sanitario en la fase de atención aguda de estas patologías, cuando no son directamente el motivo de consulta del paciente (AU)

Objective: To determine the prevalence of cocaine use among patients seen in the emergency department of a tertiary hospital for trauma or cardiovascular disorders and in whom there was no obvious relationship with cocaine use and none was spontaneously declared by the patient. We also analyzed whether this substance abuse was associated with a greater use of health care resources. Material and methods: Between October 2005 and September 2006, urine samples were collected from patients over 16years of age who were seen in the emergency department for trauma of any severity or chest pain of probable cardiovascular origin. The cocaine levels were measured in urine using a semi quantitative fluorescence polarization immunoassay. Results: We studied 325 cases, 206 with trauma and 119 with chest pain. The overall prevalence of undisclosed use was19.7%; the prevalence was 18.9% among trauma patients and 21% among those with chest pain. In cases of trauma, cocaine use was significantly associated with more frequent requests for blood tests (P < .05), whereas no differences in the use of health care resources for chest pain patients were observed. Conclusions: There is a high prevalence of undisclosed cocaine use among patients attending an emergency department in relation to cardiovascular complaints or trauma. When cocaine use is not the direct reason for the patient’s visit, it does not appear to lead to a marked variation in health care costs during the acute phase of emergency treatment (AU)

Incidence and impact of undisclosed cocaine use in emergency department chest pain and trauma patients.

BACKGROUND: One of the highest rates of illicit cocaine consumption in Europe is in Spain. Our objective was to study the incidence and impact of undisclosed cocaine consumption in patients attending the emergency department (ED) for trauma or chest pain. METHODS: We analysed urine samples from consecutive patients attending the ED for trauma or chest pain to determine the presence of cocaine, cannabis, amphetamine/metaamphetamine and opioids by semiquantative tests with fluorescence polarization immunoassay (FPIA). RESULTS: Thirty percent of eligible patients participated. Of 75 cases, 61.3% had trauma and 38.7% chest pain; 25% presented a positive test for drugs. Cocaine was present in 13.3% and cannabis in the same proportion. No differences were found regarding positive cocaine test and chief complaint, ED or hospital stay, or additional tests. Cocaine-positive patients were significantly younger.