Methamphetamine and traumatic brain injury outcomes: an analysis of 29,416 patients from the national trauma data bank

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ABSTRACT Background Methamphetamine (Meth) use is rising in the US. Most research focuses on severe TBI, neglecting milder cases. We evaluated Meth’s impact on patient outcomes and hospital resource use across all TBI severities. Methods This study included National Trauma Data Bank (NTDB) patients from 2017–2019, aged 18–54, with near-isolated TBI, a drug screen, and negative blood alcohol. Meth+ patients were compared to Meth- patients on demographics, injury severity, and outcomes using χ² and Wilcoxon rank-sum tests. Results Of 29,416 patients with TBI patients, 337 (1%) were Meth+. Meth+ patients had significantly higher ICU admissions (61% vs. 50%, p < 0.001), mechanical ventilation (32% vs. 22%, p < 0.001), and tracheostomy (7% vs. 4%, p < 0.008). Meth+ had longer hospital stays (median 4 vs. 3 days, p < 0.001) and higher cerebral monitor use (8% vs. 5%, p < 0.05). Mortality rates were similar (5% vs. 5%, p = 0.46). Meth+ patients had more preexisting mental health/personality (20% vs. 12%, p < 0.001) and substance use disorders (44% vs. 6%, p < 0.001). Conclusions Meth use in patients with near-isolated TBI patients is linked to greater injury severity, increased resource use, and longer hospital stays but does not significantly impact mortality. Targeted interventions are needed to manage clinical challenges and optimize resource utilization.