Abstract
Background: Substance Use Disorder (SUD) is common among patients admitted to the hospital, with particularly high rates among those hospitalized for trauma. It is important to further understand the clinical outcomes of trauma patients with SUD, a key metric for which is hospital length of stay (LOS). There is little existing evidence on the relationship between SUD and LOS in trauma patients. We investigated the impact of pre-existing SUD on hospital LOS in admitted trauma patients.
Methods: We performed a retrospective analysis on trauma patients admitted to our Level I Trauma Center between January 2021 and August 2023. Patients were categorized into two major groups: those with and without a history of SUD based on diagnoses in their electronic health records. Descriptive and regression analyses were performed to estimate the effect of SUD on hospital LOS.
Results: The study comprised 2,994 trauma patients aged 18 or older. 37.9% had documented SUD. Patients with SUD were younger (mean age 40.88 vs. 58.99 years, p<.001) and predominantly male (72.9% vs. 53.3%, p<.001). SUD patients had a higher mean ISS score and higher rates of alcohol use disorder, bipolar disorder, and smoking, whereas non-SUD patients had higher rates of diabetes mellitus and hypertension. There was no statistically significant difference in mean LOS (p=.51) and mean ICU days(p=.95) between the two groups. On multivariable regression analysis, age and ISS (moderate and severe) were statistically significant predictors of LOS, and SUD's impact on LOS was not statistically significant (B=0.516, p=.056).
Conclusion: Although SUD does not appear to have a clear relationship with LOS in trauma patients, it is linked to several factors that complicate management. A multidisciplinary approach to these challenges may improve outcomes.
Keywords
Substance use disorder,Trauma, Mortality, Length of stay, Injury severity score, Age, Substance use