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Urine toxicology screening in Austrian trauma patients: a prospective study

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The question as to whether the patient consumed drugs prior to the trauma and which drugs were consumed, is of prime importance for the anesthesia required during surgery. However, many patients are unwilling or unable (including those with multiple trauma or impaired consciousness, or unconscious patients) to answer this question. The purpose of our prospective multicenter study was to collect data about drug consumption in Austria to determine whether drugs are identifiable in the urine of recently injured individuals and to establish the types of drugs consumed.

Materials and methods

This prospective study included severely and moderately injured patients admitted to the Lorenz Boehler Trauma Hospital (Vienna, Austria), the Trauma Hospital Linz (Linz, Austria) and the Department of Trauma Surgery of the General Hospital Horn (Horn, Austria) during an 18-month period (October 2003–March 2005). All patients were suffering from injuries urgently requiring surgery.

Urine samples were gained from all patients immediately after admission. Urinary samples were tested by Immuno-Assay (Triage™ 8 Immuno-Assay, Biosite®, San Diego, USA). Urine samples were screened simultaneously for opiates, methadone, cocaine, barbiturates, amphetamines, cannabinoids, benzodiazepines and tricyclic antidepressants.

Results

Our prospective study included a total of 664 patients (320 from Vienna, 193 from the city of Linz, and 151 from Horn). Six hundred and forty-two patients were moderately injured (ISS < 16), suffering mostly from injuries to the extremities (504 patients) and 22 patients were severely injured (ISS > 16).

Of the 664 patients, 178 (26.8%) tested positive for one or more drugs. The drugs most commonly detected were benzodiazepines (111 patients, 16.7%), cannabinoides (39 patients, 6%), tricyclic antidepressants (28, 4.2%) and opiates (26, 3.9%).

Conclusion

Drug use is widespread in patients presenting to urban trauma centers in Austria.

Physicians should maintain a high index of suspicion that their patients may be intoxicated and should perform drug testing routinely.

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Acknowledgments

The study was funded by a Grant from AUVA (Austrian Workers′ Compensation Board), Vienna, Austria

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Authors and Affiliations

  1. Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Trauma Research Center of the Austrian Workers′ Compensation Board, Vienna, Austria

    Markus Figl, Linda E. Pelinka, Patrick Weninger, Albert Kroepfl, Robert Schmidhammer & Heinz Redl

  2. Department of Trauma Surgery, Trauma Hospital Lorenz Boehler, Donaueschingenstrasse 13, 1200, Vienna, Austria

    Markus Figl, Patrick Weninger & Harald Hertz

  3. Department of Anesthesia and Critical Care Medicine, Trauma Hospital Lorenz Boehler, Vienna, Austria

    Linda E. Pelinka & Walter Mauritz

  4. Department of Trauma Surgery, Trauma Hospital Linz, Linz, Austria

    Albert Kroepfl & Robert Schmidhammer

  5. Department of Trauma Surgery, General Hospital Horn, Horn, Austria

    Christoph Walchetseder & Walter Buchinger

Authors
  1. Markus Figl
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  2. Linda E. Pelinka
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  3. Patrick Weninger
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  4. Christoph Walchetseder
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  5. Walter Mauritz
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  6. Harald Hertz
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  7. Albert Kroepfl
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  8. Robert Schmidhammer
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  9. Walter Buchinger
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  10. Heinz Redl
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Corresponding author

Correspondence to Markus Figl.

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Figl, M., Pelinka, L.E., Weninger, P. et al. Urine toxicology screening in Austrian trauma patients: a prospective study. Arch Orthop Trauma Surg 130, 883–887 (2010). https://doi.org/10.1007/s00402-009-0995-5

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  • DOI: https://doi.org/10.1007/s00402-009-0995-5

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