Background: The protective effects of drug abuse on ICU admissions and ventilator weaning after trauma are debated. This study examines the impact of drug abuse on mortality, ICU admissions, and complications.
Methods: Trauma patients ≥16 years from the TQIP database (2020-2022) with admission toxicology testing (TOX) were analyzed. The primary outcome was mortality; secondary outcomes included in-hospital complications.
Results: Among 861,450 patients, decreased mortality odds were noted with cannabinoid (OR = 0.842), amphetamine (OR = 0.800), cocaine (OR = 0.851), opioid (OR = 0.625), and benzodiazepine (OR = 0.843) (P < 0.001). Reduced ICU admission odds were linked to opioid (OR = 0.882), barbiturate (OR = 0.824), oxycodone (OR = 0.829), ecstasy (OR = 0.811), and methadone (OR = 0.809). Lower intubation odds were seen with opioid (OR = 0.663), barbiturate (OR = 0.733), oxycodone (OR = 0.754), and ecstasy (OR = 0.627). Methamphetamine (OR = 0.682) was associated with reduced ARDS odds.
Conclusions: Recreational drugs may independently reduce ICU admissions, intubation, and mortality, warranting further investigation.
Level of evidence: Level III retrospective study.
Keywords: Drug abuse; Quality improvement; Treatment outcome; Ventilator weaning.
Copyright © 2025 Elsevier Inc. All rights reserved.