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Published on: November 14, 2012
Complications of Methamphetamine Use in Orthopaedic Trauma
John Carney1, Nicholas Trasolini, Hyunwoo P Kang
1Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA.
Objectives:
To determine whether methamphetamine (MA) users are at an increased risk for complications compared to matched controls in the setting of orthopaedic trauma.
Design:
Retrospective cohort study.
Setting:
Academic Level-1 Trauma Center.
Patients:
MA users and matched controls.
Intervention:
MA use.
Main Outcome Measurements:
Infection, Deep Vein Thrombosis (DVT), and nonunion.
Results:
Five hundred sixty-seven patients were included in our study (189 MA users, 378 matched controls). On univariate analysis, MA users had a higher incidence of DVT (3.2% vs. 0.5%), but no statistically significant difference in infection or nonunion rates. MA users also had a higher incidence of intensive care unit admission (36.0% vs. 27.8%), leaving the hospital against medical advice (9.0% vs. 2.1%), nonadherence to weightbearing precautions (18.8% vs. 7.3%), and a higher incidence of loss of follow-up (47.1% vs. 30.4%). However, MA users had a lower incidence of surgical treatment for orthopaedic injuries (51.9% vs. 65.9%). When surgical treatment was pursued, more trips to the operating room were required for orthopaedic injuries in the MA group (2.6 vs. 1.5 trips). On multivariate analysis, MA users continued to demonstrate a higher incidence of DVT and a lower incidence of operative management, but more trips to the operating room when surgical management was pursued, a higher admission rate to the intensive care unit, and a greater incidence of loss of follow-up.
Conclusions:
MA use is associated with increased inpatient and outpatient complications.
Level Of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Insights
Methamphetamine users with orthopaedic trauma face higher risks of deep vein thrombosis (DVT) and other complications. This study highlights increased hospital admissions and follow-up losses for these patients.
Area of Science:
- Orthopaedic Surgery
- Trauma Care
- Addiction Medicine
Background:
- Methamphetamine (MA) use is a growing public health concern.
- Understanding the impact of MA use on orthopaedic trauma outcomes is crucial for patient care.
- Previous research has not fully elucidated the specific risks associated with MA use in this patient population.
Purpose of the Study:
- To investigate the association between methamphetamine use and complications following orthopaedic trauma.
- To compare outcomes in methamphetamine users versus matched controls.
- To identify specific risks, including infection, deep vein thrombosis (DVT), and nonunion, in MA-using trauma patients.
Main Methods:
- Retrospective cohort study design.
- Inclusion of 567 patients (189 MA users, 378 matched controls) from an academic Level-1 Trauma Center.
- Analysis of complications including infection, DVT, and nonunion, alongside other clinical outcomes.
Main Results:
- Methamphetamine users exhibited a significantly higher incidence of DVT (3.2% vs. 0.5%).
- MA users had increased rates of intensive care unit admission, leaving against medical advice, and loss of follow-up.
- While MA users had lower rates of initial surgical treatment, they required more operating room trips when surgery was performed.
Conclusions:
- Methamphetamine use is linked to a greater risk of inpatient and outpatient complications in orthopaedic trauma patients.
- The findings underscore the need for targeted interventions and closer monitoring of MA users post-trauma.
- Further research is warranted to explore mechanisms and develop effective management strategies.
