Incidence and impact of undisclosed cocaine use in emergency department chest pain and trauma patients

Abstract

BackgroundOne of the highest rates of illicit cocaine consumption in Europe is in Spain. Our objective was to study the incidence and impact of undisclosed cocaine consumption in patients attending the emergency department (ED) for trauma or chest pain.MethodsWe analysed urine samples from consecutive patients attending the ED for trauma or chest pain to determine the presence of cocaine, cannabis, amphetamine/metaamphetamine and opioids by semiquantative tests with fluorescence polarization immunoassay (FPIA).ResultsThirty percent of eligible patients participated. Of 75 cases, 61.3% had trauma and 38.7% chest pain; 25% presented a positive test for drugs. Cocaine was present in 13.3% and cannabis in the same proportion. No differences were found regarding positive cocaine test and chief complaint, ED or hospital stay, or additional tests. Cocaine-positive patients were significantly younger.

Prevalence of cocaine use among patients attending the emergency department with chest pain

“…Studies in the USA by Hollander et al have shown the prevalence of cocaine use in patients with chest pain to be as high as 17%, with 6% to 8% of cocaine users sustaining a myocardial infarction 4 5. A recent study in Spain showed a 13.3% prevalence of cocaine use in trauma and patients with chest pain, with cocaine-positive patients being significantly younger 6. These prevalence figures are higher than found in our anonymised study, which is the first of its kind in the UK, recruiting a substantially larger sample size than the published studies from Spain and the USA.…”

La investigación en medicina de urgencias y emergencias

“…Finalmente, y como se ha mencionado anteriormente, es completamente necesario potenciar los grupos de investigación en los diferentes servicios, hospitales y sistemas de emergencias médicas de diferentes comunidades autónomas y estructurar los mecanismos para que éstos puedan trabajar de forma coordinada. Aunque existen algunos ejemplos de grupos de investigación altamente competitivos y productivos durante los últimos años, como pue-den ser los de insuficiencia cardiaca [34][35][36][37][38][39] o toxicología [40][41][42][43][44][45][46] , es imprescindible que esta actitud se generalice al grueso del campo de conocimientos de nuestro cuerpo doctrinal. Esta apuesta es fundamental, ya que debemos aunar esfuerzos para no quedar descolgados de la próxima edición del Plan Nacional de I+D+I que entrará en vigor en 2012 y, en general, de la Estrategia Nacional de Ciencia y Tecnología 47 .…”