{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:20:39Z","timestamp":1787768439144,"version":"build-2784847793"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"\n Introduction<\/jats:title>\n Substance use is a known risk factor for traumatic injury. While prior studies have evaluated outcomes associated with individual substances, there is a paucity of literature comparing outcomes across multiple drug classes. This study aimed to compare 30-day mortality and in-hospital complications among trauma patients with positive vs negative urine drug screens (UDS).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective study using the American College of Surgeons Trauma Quality Improvement Program (TQIP) database from 2013 to 2021. Adult patients aged 18-90 years with a recorded UDS were included, and those with polysubstance use were excluded. Positive UDS was defined as detection of amphetamines, barbiturates, cocaine, methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), phencyclidine (PCP), tricyclic antidepressants (TCA), or cannabinoids. Each positive cohort was matched to a negative cohort by age, sex, and injury severity score. Logistic regression was used to estimate odds ratios (ORs).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 704,033 patients were included. Positive screens for amphetamines (OR 0.82,\n P<\/jats:italic>\n < 0.001), cocaine (OR 0.78,\n P<\/jats:italic>\n < 0.001), and cannabinoids (OR 0.67,\n P<\/jats:italic>\n < 0.001) were associated with lower odds of 30-day mortality. No significant mortality differences were observed for other substances. Higher odds of in-hospital complications were observed for TCA (OR 1.74), PCP (OR 1.61), methamphetamine (OR 1.41), cocaine (OR 1.30), amphetamines (OR 1.22), and cannabinoids (OR 1.11) (all\n P<\/jats:italic>\n < 0.001), barbiturates and MDMA were not significant.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Substance-specific differences exist in trauma outcomes. While some substances are associated with decreased mortality, many are associated with increased complications, suggesting a need to prioritize complication-focused management. Limitations include underreporting of substance use.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348261480799","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:21:52Z","timestamp":1787552512000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dissecting the Impact of Substance Use on Trauma: High Morbidity Does Not Uniformly Dictate Increased Mortality"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6103-299X","authenticated-orcid":false,"given":"Dallas T.","family":"Ryan","sequence":"first","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Matecki","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayati","family":"Atahar","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Lee","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4688-1523","authenticated-orcid":false,"given":"Susan","family":"Kartiko","sequence":"additional","affiliation":[{"name":"The George Washington University School of Medicine and Health Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000600"},{"key":"e_1_3_5_3_2","doi-asserted-by":"crossref","unstructured":"Cairns CKK. National hospital ambulatory medical care survey: 2022 emergency department summary tables. https:\/\/ftp.cdc.gov\/pub\/Health_Statistics\/NCHS\/","DOI":"10.15620\/cdc:121911"},{"issue":"5","key":"e_1_3_5_4_2","first-page":"461","article-title":"The prevalence and effect of alcohol and drug abuse on cohort-matched critically injured patients","volume":"64","author":"Cornwell EE3","year":"1998","unstructured":"Cornwell EE3, Belzberg H, Velmahos G, et al. The prevalence and effect of alcohol and drug abuse on cohort-matched critically injured patients. Am Surg. 1998;64(5):461-465.","journal-title":"Am Surg"},{"key":"e_1_3_5_5_2","unstructured":"Voas RB Lacy JC. Report: alcohol and highway safety a review of the state of knowledge. https:\/\/www.nhtsa.gov\/staticfiles\/nti\/pdf\/811374.pdf"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108763"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005331"},{"key":"e_1_3_5_8_2","unstructured":"SAMHSA releases annual national survey on drug use and health. 2025. https:\/\/www.samhsa.gov\/newsroom\/press-announcements\/20250728\/samhsa-releases-annual-national-survey-on-drug-use-and-health"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211069789"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001672"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-018-0112-6"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111764"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2021-000749"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2023.06.024"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.010024"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2025.116332"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003928"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-023-00459-0"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2006.05.002"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261480799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261480799","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261480799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:51:28Z","timestamp":1787766688000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261480799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":18,"alternative-id":["10.1177\/00031348261480799"],"URL":"https:\/\/doi.org\/10.1177\/00031348261480799","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]},"article-number":"00031348261480799"}}