{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T13:56:15Z","timestamp":1786802175452,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Drug and alcohol intoxication is common among injured patients altering trauma presentation and characteristics. However, uncertainty exists regarding the effect of intoxication on injury severity, as well as outcomes. The present study aims to provide an update on substance\u2010use patterns and their association with traumatic presentation and outcome within a contemporary Australian context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All major trauma patients captured in our centre's Trauma Registry between July 2010 and June 2020 were included. Demographic, injury characteristic, outcome and substance\u2010use data were collected. Differences in injury severity and characteristics were explored using <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> tests, while outcomes were modelled using adjusted binomial logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 9700 patients, 9% were drug\u2010intoxicated prior to injury, while 9.4% were alcohol\u2010intoxicated. Drug use almost tripled between 2010 (4.8%) and 2020 (13.3%), while alcohol intoxication fell, from 11.7% to 7.3%, over the same period. Although there were significant differences in trauma mechanism among intoxicated patients, group comparison found no difference in Injury Severity Score for any group. Regarding outcomes, all intoxication resulted in significantly greater odds (odds ratio 1.62\u20132.41) of ICU admission. No difference in mortality was found among individual substance\u2010use groups; however, polysubstance\u2010intoxicated patients had 3.52 times greater odds of dying (95% confidence interval 1.21\u201310.23) compared to non\u2010intoxicated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Within this contemporary Australian population, we demonstrate escalating rates of drug intoxication and declining rates of alcohol intoxication prior to trauma. Intoxication was associated with more frequent violent and non\u2010accidental injury, and despite no difference in severity, it was associated with worse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14231","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:24:51Z","timestamp":1683591891000},"page":"792-798","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4593-0418","authenticated-orcid":false,"given":"Jonathan","family":"Woliansky","sequence":"first","affiliation":[{"name":"Trauma Service The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie","family":"Gumm","sequence":"additional","affiliation":[{"name":"Trauma Service The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Clark","sequence":"additional","affiliation":[{"name":"Addiction Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1503-0440","authenticated-orcid":false,"given":"Jonathan","family":"Knott","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Read","sequence":"additional","affiliation":[{"name":"Trauma Service The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-1600.2008.00129.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050977"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1993.01420200081015"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.142.7.633"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198904000-00008"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-2897-5-3"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318184821d"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1300\/J069v21n04_01"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.02.011"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000152638.54978.53"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000157133.80396.1c"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00778.x"},{"key":"e_1_2_9_14_1","volume-title":"Committee on Trauma. 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