Trauma under the influence: A review of drug and alcohol-related major trauma in North Queensland

Abstract

Objective Alcohol and drug use is an established factor contributing to traumatic injury globally. However, its prevalence and impact within regional and remote populations is poorly characterised. This study examines associations between alcohol and drug use and clinical outcomes among major trauma patients in North Queensland. Methods A retrospective audit was conducted of all major trauma patients in the Townsville University Hospital Trauma Registry Information System between October 2022 and October 2023. Demographic, injury and outcome data were investigated. Patients were categorised by alcohol and drug use and compared using descriptive and non-parametric analysis. Results Of 319 eligible patients, 110 (34.4%) patients were identified within the alcohol and drug cohort. Alcohol was most frequently detected (82.7%) followed by cannabis (20.0%) and amphetamines (12.7%) and 20 (18.2%) reported polysubstance use. Alcohol and/or drug-positive patients were significantly younger (40.7 vs 49.0 years, p<0.05), more likely to be injured by assault (OR 6.9 (95% CI: 3.1-15.3), p<0.001), admitted to ICU (OR 1.5 (95% CI: 0.9-2.5), p=0.069) and required longer hospital stays (11.9 +/- 13.9 days vs 10.4 +/- 11.4 days, p=0.656). Discharge and mortality outcomes did not differ between groups. Conclusion This study highlights the impact of alcohol and drug use in regional major trauma patients, who often require greater healthcare utilisation. Standardised testing, targeted prevention and tailored clinical pathways may improve outcomes and reduce the burden of alcohol and drug-related trauma. Due to the inconsistent screening practices, the true prevalence remains uncertain, warranting further research to determine the impact and guide interventions.

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