Substance use in rural trauma patients admitted for motor vehicle injuries before and during the COVID-19 pandemic

Risk factors associated with driving after marijuana use among West Virginia college students during the COVID-19 pandemic

OBJECTIVES

The purpose of this study was to assess sociodemographic and behavioral risk factors associated with driving after marijuana use (DAMU) among West Virginia college students.

METHODS

Participants were recruited from West Virginia University between September and November 2022. The study sample was restricted to students who were ≥18 years of age; reported recently driving; possessed a current, valid driver's license from any US state; and were enrolled for at least one credit hour in the Fall 2022 semester.

RESULTS

Among respondents (N = 772), 28.9% reported DAMU. Students who had a GPA of B (adjusted odds ratio [AOR]: 2.17, 95% confidence interval [CI]: 1.06-4.42), smoked or ingested marijuana in the past year (AOR: 26.51, 95% CI: 10.27-68.39), drove after drinking (AOR: 2.38, 95% CI: 1.18-4.79), and used both marijuana and alcohol concurrently and then drove (AOR: 10.39, 95% CI: 2.32-46.54) associated with DAMU. Individuals who felt the behavior was somewhat dangerous or not dangerous or thought their peers approved of DAMU showed significant associations with DAMU.

CONCLUSIONS

As DAMU was prevalent, future interventions that raise awareness of the danger and potential consequences of DAMU may be needed to reduce this risky behavior on college campuses.

Prevalence of Acute Alcohol Use in Traumatic Brain Injury Patients During the COVID-19 Pandemic: A Retrospective Analysis From Queens, New York

Background This study investigates the impact of New York's relaxed alcohol consumption policies during the coronavirus disease (COVID-19) pandemic on alcohol-related traumatic brain injuries (TBIs) among patients admitted to a Level 1 trauma center in Queens. Given the limited research available, this study critically explores the link between public health policies and trauma care. It aims to address a significant gap in the literature and highlight the implications of alcohol regulations during global health emergencies. Methodology A retrospective analysis was conducted among trauma patients from 2019 to 2021. The study period was divided into the following three periods: pre-lockdown (March 7, 2019, to July 31, 2019), lockdown (March 7, 2020, to July 31, 2020), and post-lockdown (March 7, 2021, to July 31, 2021). Data on demographics, injury severity, comorbidities, and outcomes were collected. The study focused on assessing the correlation between New York's alcohol policies and alcohol-related TBI admissions during these periods. Results A total of 1,074 admissions were analyzed. The study found no significant changes in alcohol-positive patients over the full calendar years of 2019, 2020, and 2021 (42.65%, 38.91%, and 31.16% respectively; p = 0.08711). Specifically, during the lockdown period, rates of alcohol-positive TBI patients remained unchanged, despite the relaxed alcohol policies. There was a decrease in alcohol-related TBI admissions in 2021 compared to 2020 during the lockdown period. Conclusions Our study concludes that New York's specific alcohol policies during the COVID-19 pandemic were not correlated with an increase in alcohol-related TBI admissions. Despite the relaxation of alcohol consumption laws, there was no increase in alcohol positivity among TBI patients. The findings suggest a complex relationship between public policies, alcohol use, and trauma during pandemic conditions, indicating that factors other than policy relaxation might influence alcohol-related trauma incidences.

Descriptive Analysis of Trauma Admission Trends before and during the COVID-19 Pandemic

INTRODUCTION

Traumatic injuries are a significant global health concern, with profound medical and socioeconomic impacts. This study explores the patterns of trauma-related hospitalizations in the Lublin Province of Poland, with a particular focus on the periods before and during the COVID-19 pandemic.

AIM OF THE STUDY

The primary aim of this research was to assess the trends in trauma admissions, the average length of hospital stays, and mortality rates associated with different types of injuries, comparing urban and rural settings over two distinct time periods: 2018-2019 and 2020-2021.

METHODS

This descriptive study analyzed trauma admission data from 35 hospitals in the Lublin Province, as recorded in the National General Hospital Morbidity Study (NGHMS). Patients were classified based on the International Classification of Diseases Revision 10 (ICD-10) codes. The data were compared for two periods: an 11-week span during the initial COVID-19 lockdown in 2020 and the equivalent period in 2019.

RESULTS

The study found a decrease in overall trauma admissions during the pandemic years (11,394 in 2020-2021 compared to 17,773 in 2018-2019). Notably, the average length of hospitalization increased during the pandemic, especially in rural areas (from 3.5 days in 2018-2019 to 5.5 days in 2020-2021 for head injuries). Male patients predominantly suffered from trauma, with a notable rise in female admissions for abdominal injuries during the pandemic. The maximal hospitalization days were higher in rural areas for head and neck injuries during the pandemic.

CONCLUSIONS

The study highlights significant disparities in trauma care between urban and rural areas and between the pre-pandemic and pandemic periods. It underscores the need for healthcare systems to adapt to changing circumstances, particularly in rural settings, and calls for targeted strategies to address the specific challenges faced in trauma care during public health crises.

Prevalence of Substance Abuse Among Trauma Patients in Rural West Virginia

BACKGROUND

 Substance abuse poses considerable clinical, economic, and social challenges. West Virginia is hailed as the epicenter of the substance abuse in the United States, the prevalence and pattern of different trauma mechanisms in a rural context or in patients with different forms of substance abuse remain unclear.

OBJECTIVE

 We performed the following analysis to understand the prevalence of substance abuse in patients with different trauma mechanisms in the rural setting with high substance abuse in the West Virginia.

METHODS

 We performed a cross-sectional retrospective analysis of adult trauma patients (motor vehicle, fall, assault, firearm suicide, brawl/rape and machinery) hospitalized in two tertiary care hospitals in West Virginia between 2006 and 2016. We identified all patients who had a urine drug screen (UDS) test and extracted the data related to the substance and trauma.

RESULTS

 Among 8734 patients screened using UDS, 5940 (68.1%) patients were tested positive for the substance. Opiates, alcohol, benzodiazepines, and cannabis were the four most common substances identified in trauma victims. In all instances, the prescribed drug was less than 20%. Fatal outcome was observed in 366 patients in the sample, with 44% (n=162) testing positive for UDS, 12% (n=45) testing positive for only alcohol, and 15% (n=56) testing positive for both alcohol and UDS. Regarding the trauma mechanism, the motor vehicle accident (MVA) was the most prominent with a clear association of substance abuse with fatal outcome.

CONCLUSION

 The most prevalent trauma mechanism was a MVA, with a strong link between drug usage and mortality. Due to the high incidence of positive substance abuse screens, UDS tests may need to be more widely implemented in trauma in the West Virginia region. The findings of this study might help in establishing regional or national policies to reduce acute substance abuse.