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

Abstract

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 5-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 2 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) whereas the other had sEtOH or an other-than-PCP–positive UDS (other-drug group). Subgroup analysis was performed comparing PCP-positive patients with undetectable sEtOH with other-drug patients with undetectable sEtOH. ResultsThe registry contained 7770 patients of which 156 met inclusion criteria. The mean age was 33.4years (range, 19-63), and 77% were male (n=121). When compared with the other-drug group, the PCP-positive group had significantly lower injury severity score, rates of intensive care unit admission, and sEtOH. No difference was seen in vital signs, mechanism of injury, ventilator days, intensive care unit days, total hospital days, disposition, or mortality between the 3 groups. This remained true even when subgroups with negative sEtOH were compared. ConclusionThis study suggests that a PCP-positive UDS in the setting of trauma is not associated with increased level of care, length of stay, or mortality.