101.03 Alarming Rate of Controlled Substance Use in Motor Vehicle Collisions at an Appalachian Trauma Center

Posted on January 31, 2019

R. E. Proctor1, M. P. Taylor1, M. A. Quinn2, J. B. Burns1  1East Tennessee State University,Department Of Surgery,Johnson City, TENNESSEE, USA 2East Tennessee State University,College Of Public Health,Johnson City, TENNESSEE, USA

Introduction:

Recent studies show an increased risk of motor vehicle collisions with controlled substance use and an overall increasing rate of opioid-positive fatalities. There is limited national data on outcomes of patients with controlled substance use presenting to trauma centers after motor vehicle collisions. The Appalachian region is known to have significant substance abuse within the population, and we aimed to identify the rate of controlled substance use and outcomes in patients who presented to a Level 1 Trauma Center after motor vehicle collision. 

Methods:

Data from our National Trauma Registry American College of Surgeons System (NTRACS) was collected for motor vehicle collision and motorcycle crash patients presenting to a single Level 1 Trauma Center between 2011-2015. Demographic and outcome data were analyzed based on the presence or absence of controlled substance use obtained by self-reporting or from screening on presentation.

Results:

There were a total of 2,570 patients, with 768 (29.9%) individuals using a controlled substance. 33% of drivers were found to be using a controlled substance. Non-motorcycle crash, driver position in vehicle, and male sex were significantly associated with presence of a controlled substance (p<0.01). There was a similar mortality rate in both groups (2.8% vs 3.6%) with no significant difference in hospital length of stay (LOS), ICU LOS, ventilator days, or injury severity score.

Conclusion:

In patients who presented to our trauma center after a motor vehicle collision, there was no difference in mortality or measured outcomes. However in this single institution review, our rate of controlled substance use in motor vehicle collision patients was observed to be much higher than the national average and thus warrants increased public outreach programs and further study in our community and greater Appalachia.