Patients admitted to hospital after an injury are often found to have used psychoactive substances prior to the injury. The aim of this study was to investigate the associations between psychoactive substances (alcohol, psychoactive medicinal drugs and illicit drugs) and previous hospital admissions, triage and length of stay in the arctic Norwegian county of Finnmark. Patients ≥ 18 years admitted due to injury to trauma hospitals in Finnmark from January 2015 to August 2016 were approached. Parameters regarding admittance and hospital stay were collected from 684 patients and blood was analysed for psychoactive substances. Using a prospective, observational design, time, triage, length of stay in hospital, use of intensive care unit (ICU), injury severity, Alcohol Use Disorder Identification Test—Consumption (AUDIT-C) and number of previous admittances were investigated by bivariable testing and logistical regression analysis. Of 943 patients approached, 81% consented and 684 were included in the study. During the weekend, 51.5% tested positive for any substance versus 27.1% Monday–Friday. No associations were identified between testing positive and either triage or injury severity for any substance group although triage level was lower in patients with AUDIT-C ≥ 5. Short length of stay was associated with alcohol use prior to injury [odds ratio (OR) 0.48 for staying > 12 h, confidence interval (CI) 0.25–0.90]. The OR for staying > 24 h in the ICU when positive for an illicit substance was 6.33 (CI 1.79–22.32) while negatively associated with an AUDIT-C ≥ 5 (OR 0.30, CI 0.10–0.92). Patients testing positive for a substance had more often previously been admitted with the strongest association for illicit drugs (OR 6.43 (CI 1.47–28.08), compared to patients in whom no substances were detected. Triage level and injury severity were not associated with psychoactive substance use. Patients using alcohol are more often discharged early, but illicit substances were associated with longer ICU stays. All psychoactive substance groups were associated with having been previously admitted.

中文翻译：

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农村伤害中的精神活性物质与既往入院、分诊和住院时间：一项前瞻性观察研究

受伤后入院的患者经常被发现在受伤前使用过精神活性物质。本研究的目的是调查精神活性物质（酒精、精神活性药物和非法药物）与北极挪威芬马克郡既往住院、分诊和住院时间之间的关系。研究人员接触了 2015 年 1 月至 2016 年 8 月期间芬马克郡创伤医院因受伤住院的 18 岁以上患者。从 684 名患者中收集了有关入院和住院时间的参数，并分析了血液中的精神活性物质。采用前瞻性、观察性设计，通过双变量对时间、分诊、住院时间、重症监护病房 (ICU) 的使用、伤害严重程度、酒精使用障碍识别测试 - 消耗 (AUDIT-C) 和之前入院的次数进行调查测试和逻辑回归分析。在 943 名患者中，81% 表示同意，684 名患者被纳入研究。周末期间，51.5% 的人任何物质检测呈阳性，而周一至周五这一比例为 27.1%。尽管在 AUDIT-C ≥ 5 的患者中分诊水平较低，但在任何物质组中，检测呈阳性与分诊或损伤严重程度之间均未发现关联。短期住院时间与受伤前饮酒有关 [比值比 (OR) 0.48停留 > 12 小时，置信区间 (CI) 0.25–0.90]。当非法物质呈阳性时，在 ICU 停留 > 24 小时的 OR 为 6.33 (CI 1.79–22.32)，而与 AUDIT-C ≥ 5 呈负相关（OR 0.30，CI 0.10–0.92）。与未检测到物质的患者相比，物质检测呈阳性的患者以前更常因非法药物的最强关联而入院（OR 6.43 (CI 1.47–28.08)）。分诊水平和伤害严重程度与精神活性物质无关使用酒精的患者通常会提前出院，但非法药物与 ICU 停留时间较长有关。所有精神活性物质组都与之前入院有关。