Association of Methamphetamine Use with Venous Thromboembolism After Blunt Trauma Admission

Introduction: Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in trauma patients. While multiple risk factors for VTE have been identified, substance use remains understudied. We analyzed the Trauma Quality Improvement Program (TQIP) database to investigate whether methamphetamine(METH)-use is associated with VTE among adult blunt trauma patients.

Methods: Retrospective analysis of the TQIP database identified adult blunt trauma patients (≥18 years old) admitted from 2019-2021. The primary outcome was VTE occurrence during hospitalization. Patient demographics, Injury Severity Score (ISS), and hospital-level factors were analyzed. Univariate, multivariate, and multivariable logistic regression analyses were performed.

Results: Among 2,693,470 blunt trauma patients, 28,065 tested positive for METH upon admission, with 371 (1.19%) subsequently developing VTE. VTE was more common in blunt trauma patients with METH-use (1.1% vs. 0.7%, p < 0.001). Compared to non-use, METH-use was associated with greater ISS (26.2% vs. 16.1%, p < 0.001), alcohol use (70.8% vs. 42.8%, p < 0.001), worse neurological status (9.8% vs. 4.7%, p < 0.001), longer hospitalization (7.9 vs. 6.4 days, p < 0.001), and ICU admission (5.9 vs. 5.2 days, p < 0.001). After adjusting for confounders, METH-use was associated with 13.8% greater odds of developing VTE (adjusted Odds Ratio (aOR) = 1.14, p = 0.018). METH-use had 66.0% greater odds of severe injury compared to non-users (aOR = 1.66, p < 0.001).

Conclusion: Among blunt trauma patients, METH-use is associated with increased odds of VTE. These findings underscore the importance of risk-stratification and targeted interventions in this high-risk population.