Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 10 , ISSUE 2 ( May-August, 2021 ) > List of Articles

Original Article

Trauma Outcomes in Methamphetamine-positive Patients vs Matched Methamphetamine-negative Controls in a Central Valley California Trauma Center

Jacob Kirkorowicz, Nichole Atherton, Yueqi Yan

Keywords : Abdominal trauma, Celiotomy, Critical care, Mortality rate, Outcomes, Penetrating injuries

Citation Information : Kirkorowicz J, Atherton N, Yan Y. Trauma Outcomes in Methamphetamine-positive Patients vs Matched Methamphetamine-negative Controls in a Central Valley California Trauma Center. Panam J Trauma Crit Care Emerg Surg 2021; 10 (2):66-70.

DOI: 10.5005/jp-journals-10030-1323

License: CC BY-NC 4.0

Published Online: 27-08-2021

Copyright Statement:  Copyright © 2021; The Author(s)


Aim and objective: Our objective was to determine whether patients presenting as activated traumas to a trauma center serving a high methamphetamine (meth) prevalence region differed in outcomes based on whether they tested positive vs negative for methamphetamine at the time of presentation. Materials and methods: A case-control design was used to examine the trauma outcomes among patients who tested meth-positive vs matched controls. The trauma outcomes evaluated were needed for laparotomy, rate of inpatient admission, rate of ICU admission, hospital length of stay, ICU length of stay, ventilation status, ventilation time, injury severity score, and mortality. Propensity score matching was used to match meth-positive cases and comparison cases on sex, age (in years), race, primary financial resources to pay for the visit, presentation time, and the county where s/he lived at the time of presentation. Results: Meth-positive patients and matched comparison cases did not differ in the need for laparotomy. Meth-positive patients experienced a longer hospital stay (p = 0.011), longer duration of ventilator use (p = 0.05), and a higher injury severity score (p < 0.001). Positive cases were more likely than matched comparison cases to be admitted to the ICU (p < 0.001) and to be placed on mechanical ventilation (p < 0.001). Meth-positive patients had a marginally significantly higher rate of inpatient admission (p = 0.066). No significant difference was found between the two groups in mortality rate at discharge and length of ICU stays. Conclusion: Meth positivity is notably associated with an increased injury severity score on presentation. If meth use is known or suspected before arrival, trauma resources should be mobilized appropriately to prepare for a severe traumatic injury. The fact that meth positivity increases the likelihood of ICU admission and ventilator use, with increased hospital length of stay and increased ventilator time, indicates that meth positivity in trauma patients places a large burden on hospital staffing and resources.

  1. [cited 2021 Jul 30]. Available from:
  2. Gruenewald PJ, Ponicki WR, Remer LG, et al. Mapping the spread of methamphetamine abuse in California from 1995 to 2008. Am J Public Health 2013;103(7):1262–1270. DOI: 10.2105/AJPH.2012.300779.
  3. Syvertsen JL, Paquette CE, Pollini RA. Down in the valley: Trajectories of injection initiation among young injectors in California's Central Valley. Int J Drug Policy 2017;44:41–49. DOI: 10.1016/j.drugpo.2017.03.003.
  4. Hadjizacharia P, Green DJ, Plurad D, et al. Methamphetamines in trauma: effect on injury patterns and outcome. J Trauma 2009;66(3):895–898. DOI: 10.1097/TA.0b013e318164d085.
  5. Neeki MM, Dong F, Liang L, et al. Evaluation of the effect of methamphetamine on traumatic injury complications and outcomes. Addict Sci Clin Pract [Internet] 2018;13(1):1–7. DOI: 10.1186/s13722-018-0112-6.
  6. Schermer CR, Wisner DH. Methamphetamine use in trauma patients: a population-based study. J Am Coll Surg 1999;189(5):442–449. DOI: 10.1016/s1072-7515(99)00188-x.
  7. Sheridan J, Bennett S, Coggan C, et al. Injury associated with methamphetamine use: a review of the literature. Harm Reduct J 2006;3(1):14. DOI: 10.1186/1477-7517-3-14.
  8. London JA, Utter GH, Battistella F, et al. Methamphetamine use is associated with increased hospital resource consumption among minimally injured trauma patients. J Trauma 2009;66(2):485–490. DOI: 10.1097/TA.0b013e318160e1db.
  9. Tominaga GT, Garcia G, Dzierba A, et al. Toll of methamphetamine on the trauma system. Arch Surg 2004;139(8):844–847. DOI: 10.1001/archsurg.139.8.844.
  10. Swanson SM, Sise CB, Sise MJ, et al. The scourge of methamphetamine: impact on a level I trauma center. J Trauma 2007;63(3):531–537. DOI: 10.1097/TA.0b013e318074d3ac.
  11. Doddamreddy P, Tulyagankhodjaev J, Ives C, et al. Critical illness associated with methamphetamine exposure in the Central Valley of California (CRIME). Chest 2016;150(4):333A. DOI: 10.1016/j.chest.2016.08.346.
  12. London JA, Battistella FD. Testing for substance use in trauma patients: are we doing enough?: Are we doing enough? Arch Surg 2007;142(7):633–638. DOI: 10.1001/archsurg.142.7.633.
  13. Austin PC. Statistical criteria for selecting the optimal number of untreated subjects matched to each treated subject when using many-to-one matching on the propensity score. Am J Epidemiol 2010;172(9):1092–1097. DOI: 10.1093/aje/kwq224.
  14. Austin PC. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat 2011;10(2):150–161. DOI: 10.1002/pst.433.
  15. Henningfield JE, Clayton R, Pollin W. Involvement of tobacco in alcoholism and illicit drug use. Addiction 1990;85(2):279–292. DOI: 10.1111/j.1360-0443.1990.tb03084.x.
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