• Farid F Muakkassa, Robert A Marley, Joan Dolinak, Ann E Salvator, and Meredith C Workman.
• Department of Trauma, Akron General Medical Center, Akron, OH 44307, USA. fmuakkassa@agmc.org
• Eur J Emerg Med. 2008 Feb 1; 15 (1): 19-25.

IntroductionThe purpose of this study was to determine whether trauma patients requiring psychiatric medication who were admitted with positive alcohol or drug screen require more pain medications or sedation resulting in longer length of stay.MethodsData were retrospectively collected from 1997 through 2003 on patients with positive alcohol or drug screen who also received psychiatric medication during their hospital stay in a trauma center. Patients were matched by age, injury severity score, and injury to controls who had negative alcohol and toxicology screens and no psychiatric medication. An additional group consisted of positive alcohol or drug-screen trauma patients without psychiatric medication during hospitalization. Each group had 25 patients.ResultsNo significant differences between the three groups regarding comorbidities or pain-medication doses given per day were found. The patients with positive alcohol and with psychiatric medication were more likely to have respiratory complications such as pneumonia or respiratory failure requiring ventilator support (36 versus 4%, P=0.005), to develop other infections (8 versus 0%), or other complications (26 versus 4%, P=0.0007) compared with the controls. A significant difference in hospital length of stay between the group with positive toxicity and psychiatric medication and that with negative toxicity and psychiatric medication (mean: 12.8 and 5.5 days, respectively; P=0.01) was found.ConclusionPsychiatric medication and positive drug or alcohol screens are associated with longer length of stay and increased respiratory complications. Factors influencing these outcomes need more clarification and prospective studies.

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