El consumo de alcohol y/o drogas favorece la reincidencia en el traumatismo y reduce el período sin traumatismos / Alcohol and/or drug abuse favors trauma recurrence and reduces the trauma-free period

RESUMEN

Objetivo Nuestro objetivo ha sido determinar la influencia del consumo de alcohol y/o drogas en la reincidencia de pacientes traumatizados y, en pacientes no reincidentes, analizar el papel de estas sustancias en el tiempo de aparición del primer episodio de traumatismo. Diseño Estudio observacional prospectivo. Ámbito Unidad de cuidados intensivos (UCI) de un hospital terciario. Pacientes traumatizados ingresados en UCI. Intervención Ninguna. Variables principales La reincidencia en el traumatismo se definió por antecedentes de traumatismo previo que requiriera atención médica. Se ha determinado la presencia de alcohol y otras drogas de abuso al ingreso tras un traumatismo grave. Resultados De los 166 pacientes con traumatismo ingresados en la UCI durante el período de estudio, se incluyeron 102 (87 hombres). Se detectó alguna sustancia en 51 pacientes (50%), alcohol (39%), cannabis (12%) y cocaína (7%). De los 102 pacientes, 42 eran reincidentes, de los cuales 32 (76%) dieron positivo a alguna sustancia y solo en 10 se obtuvieron resultados negativos (p<0,001). De los 60 pacientes no reincidentes, 19 (32%) dieron resultados positivos a alguna sustancia, estos últimos eran significativamente más jóvenes (34,3±9 años) que los 41 con resultados negativos (48±23 años) (p<0,001).Conclusión El consumo de alcohol y/o drogas aumenta la probabilidad de reincidencia en el traumatismo y adelanta en casi 15 años la presentación del primer traumatismo (AU)

ABSTRACT

Aim A study is made of the influence of alcohol and/or drug abuse upon traumatism o recurrence, with an analysis of the influence of such abuse upon the time to appearance of first injury in patients without antecedents of trauma. Design A prospective observational study was made. Setting Trauma patients admitted to the Intensive care Unit (ICU) of a University Hospital. Patients Trauma patients admitted to the ICU. Intervention None. Main measurements Trauma recurrence was defined by a history of previous trauma requiring medical care. The presence of alcohol and other drugs of abuse were determined upon admission after severe trauma. Results Out of the 166 trauma patients admitted to the ICU during the study period, 102 (87 males) were included in the study. Some substance was detected in 51 patients (50%), most frequently in the males (48/87, p<0.02). The most frequently detected substance was alcohol (39%), followed by cannabis (12%) and cocaine (7%), while more than one substance was found in 10 patients (9.8%). Of the 102 patients, 42 were recurrent trauma cases, and 32 (76%) of them were substance-positive, while only 10 were substance-negative (p<0.001). Of the 60 patients without antecedents of trauma, 19 (32%) were substance-positive, and these were significantly younger (34.3±9 years) than the 41 subjects who were substance-negative (48±23 years) (p<0.001).Conclusion Alcohol and/or drug abuse increases the likelihood of recurrent trauma and may shorten the mean trauma-free period among patients without a history of trauma by almost 15 years (AU)