Do trauma patients with phencyclidine positive urine drug screens have increased morbidity or mortality?

Publication date: Available online 11 March 2016
Source:The American Journal of Emergency Medicine
Author(s): Ryan Gallagher, Jonathan Dangers, Stephen L. Thornton
BackgroundPhencyclidine (PCP) use is anecdotally associated with agitation and injury and is frequently tested for in the setting of trauma. We sought to determine characteristics of trauma patients with a PCP positive urine immunoassay drug screen (UDS) and if they had increased levels of care or mortality.MethodsA five year retrospective review of a level 1 trauma center's trauma registry identified patients with a PCP positive UDS. This group was then compared with two randomly selected control groups from the same trauma registry which were matched for age and sex but differed in that one had no sEtOH detected and a negative UDS (Drug Free group) while the other had sEtOH or an other-than-PCP positive UDS (Other Drugs group). Subgroup analysis was performed comparing PCP positive patients with undetectable sETOH to Other Drug patients with undetectable sEtOH.ResultsThe registry contained 7770 patients of which 156 met inclusion criteria. The mean age was 33.4 years (range 19-63) and 77% were male (n=121). When compared to the Other Drug group the PCP positive group had significantly lower ISS, rates of ICU admission, and sEtOH. No difference was seen in vital signs, mechanism of injury, ventilator days, ICU days, total hospital days, disposition, or mortality between the three groups. This remained true even when subgroups with negative sEToH were compared.ConclusionThis study suggests a PCP positive UDS in the setting of trauma is not associated with increased level of care, length of stay, or mortality.

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