Drug Addiction In The Burn Population
Eliana FR Duraes, MD, PhD, Ashley Modica, MD, Mohammed Asif, MD, Charles S. Hultman, MD, Giulia Silkorski, MD, Julie Caffrey, DO.
Johns Hopkins, Baltimore, MD, USA.
PURPOSE: Our aim was to study the association of previous drug addiction history and the treatment of acute burn patients.
METHODS: A prospectively maintained database was queried to study acute burn patients admitted in a reference burn center from 2013 to 2018. Patients with a previous history of drug addiction (group 1) were compared to patients without it (group 2). Group 1 included patients with history of opioids abuse, heroin, cocaine, cannabis, inhalants, and alcoholism. A p0.05 was considered significant.
RESULTS: A total of 3046 patients were studied, 502 (16.5%) had previous history of drug abuse on file. Compared to group 2, group 1 had: more males - 343 (68.3%) vs 1456 (57.2%) p0.001; was younger - 45.7914.65 vs 52.0219.57 p0.001; required intubation at a higher rate - 100 (19.9%) vs 329 (12.9%)p0.001; longer intubation period - 2.4310.05 vs 1.377.71 p0.001; had a prolonged admission - 13.8728.82 vs 8.4816.58 p0.001; more surgeries - 1.213.30 vs 0.71.58 p=0.002,and a higher daily morphine milligram equivalent requirement - 148.34320.56 vs 56.0297.81. A similar expected mortality rate was calculated for both groups: 3.03% vs 3.56%p=0.483; which may be partly explained by the fact that the drug use history is not part of the formula. No significant difference was seen on the burned area between the groups.
CONCLUSION: Drug addiction is an important factor associated with the acute burn treatment algorithm, prognosis, outcome, and cost. Further studies are necessary guide the treatment of the specific needs of these increasingly common burn patients subgroup.
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