在创伤中使用可卡因:恶习悖论重新审视
A Bhullar1, J Nahmias1, A Kong1
1Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, Orange, CA.
Surgery
|July 26, 2023
概括
"恶性悖论"不适用于创伤患者使用可卡因. 可卡因使用者有类似的死亡率和血栓栓塞风险,但更经常出现穿透性创伤.
科学领域:
- 创伤外科 手术 创伤外科
- 毒理学 毒理学 毒理学
- 公共卫生 公共卫生
背景情况:
- "恶性悖论"表明,非法物质使用可能会降低创伤患者的死亡率.
- 可卡因的血管收缩作用具有双重风险:降低出血,但增加了血栓栓塞事件.
- 可卡因对创伤患者结果的影响尚不清楚.
研究的目的:
- 调查可卡因使用与创伤患者死亡风险之间的关联.
- 为了比较可卡因阳性与可卡因阴性创伤患者中血栓栓塞并发症的风险.
主要方法:
- 使用创伤质量改善计划数据库 (2017-2019).
- 包括18岁以上的患者,接受药物/酒精查.
- 排除了阳性酒精或非可卡因物质的患者,比较可卡因阳性和阴性组.
主要成果:
- 在312,553名可卡因阳性患者中,确定了11,942名 (3.82%) 的可卡因阳性患者.
- 可卡因使用者的穿透创伤 (刺伤/枪伤) 发生率更高.
- 在同变量调整后,死亡率,心肌梗塞或脑血管事故风险没有显著差异.
结论:
- "恶性悖论"不适用于创伤患者使用可卡因.
- 对可卡因阳性创伤患者的预后与对所有物质阴性患者的预后相似.
- 在可卡因使用者中,透性创伤的增加表明了高风险的环境暴露.
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