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Purpose <p>To investigate the relationship between urinary toxicology screen and traumatic femoral shaft fractures treated with intramedullary fixation, as well as assessing their impacts on morphine milligram equivalents (MME) and hospital length of stay (LOS).</p> Methods <p><Emphasis Type="BoldItalic">Design: </Emphasis>Retrospective Chart Review<Emphasis Type="BoldItalic">; Setting:</Emphasis> Single center, non-academic community level II trauma center; <Emphasis Type="BoldItalic">Patient Selection Criteria:</Emphasis> All patients who were 16&#xa0;years or older, and admitted to the hospital following a trauma activation for a femoral shaft fracture were included in the study. Exclusion criteria included patients without a urine toxicology screen, with low energy mechanisms or pathologic fractures, or those with miscoded charts. <Emphasis Type="BoldItalic">Outcome Measures and Comparisons:</Emphasis> The primary outcomes of this study were MME and hospital LOS. Patients were grouped based on whether or not they had a positive or negative urinary drug screen.</p> Results <p>A total of 144 patients met inclusion criteria having sustained femoral shaft fractures treated with intramedullary fixation. 34 patients were excluded from the study for not meeting one or more inclusion criteria. A total of 110 patients met the criteria for analysis. No positive UDS was found to correlate significantly with hospital LOS, and amongst all drugs screened for, only opiates were found to have a statistically significant increase in morphine milligram equivalents per day. Additionally, a negative UDS for opiates showed statistically significant correlation with ICU admission (<i>p</i> value 0.0273).</p> Conclusions <p>Trauma patients with a positive UDS for opioid use, and a femoral shaft fracture treated with intramedullary nail, are at an increased risk for higher MME requirements during their hospitalization, independent of ISS.</p>

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Is a positive urinary toxicology screen in femoral shaft fractures associated with longer hospital length of stay and increased opioid use?

  • 期刊论文

  • 发表日期：

    2025年7月13日

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  • Mustafa Alkhouli,
  • Eric Huish,
  • William Holmes,
  • Brendan Liakos,
  • Richard Gellman

摘要

Purpose

To investigate the relationship between urinary toxicology screen and traumatic femoral shaft fractures treated with intramedullary fixation, as well as assessing their impacts on morphine milligram equivalents (MME) and hospital length of stay (LOS).

Methods

Design: Retrospective Chart Review; Setting: Single center, non-academic community level II trauma center; Patient Selection Criteria: All patients who were 16 years or older, and admitted to the hospital following a trauma activation for a femoral shaft fracture were included in the study. Exclusion criteria included patients without a urine toxicology screen, with low energy mechanisms or pathologic fractures, or those with miscoded charts. Outcome Measures and Comparisons: The primary outcomes of this study were MME and hospital LOS. Patients were grouped based on whether or not they had a positive or negative urinary drug screen.

Results

A total of 144 patients met inclusion criteria having sustained femoral shaft fractures treated with intramedullary fixation. 34 patients were excluded from the study for not meeting one or more inclusion criteria. A total of 110 patients met the criteria for analysis. No positive UDS was found to correlate significantly with hospital LOS, and amongst all drugs screened for, only opiates were found to have a statistically significant increase in morphine milligram equivalents per day. Additionally, a negative UDS for opiates showed statistically significant correlation with ICU admission (p value 0.0273).

Conclusions

Trauma patients with a positive UDS for opioid use, and a femoral shaft fracture treated with intramedullary nail, are at an increased risk for higher MME requirements during their hospitalization, independent of ISS.