Cocaine use and its relationship with cardiovascular pathology and trauma seen in an emergency department

Burillo-Putze G, Borreguero León JM, Vallbona Afonso E, De Vera González AM, Fernández Rodríguez JF, García Dopico JA, Vega Prieto MJ, Cinesi Gómez C, Jiménez Sosa A

Objective: To determine the prevalence of cocaine use among patients seen in the

emergency department of a tertiary hospital for trauma or cardiovascular disorders and

in whom there was no obvious relationship with cocaine use and none was

spontaneously declared by the patient. We also analyzed whether this substance abuse

was associated with a greater use of health care resources.

Material and methods: Between October 2005 and September 2006, urine samples were

collected from patients over 16 years of age who were seen in the emergency department

for trauma of any severity or chest pain of probable cardiovascular origin. The cocaine levels

were measured in urine using a semiquantitative fluorescence polarization immunoassay.

Results: We studied 325 cases, 206 with trauma and 119 with chest pain. The overall

prevalence of undisclosed use was 19.7%; the prevalence was 18.9% among trauma

patients and 21% among those with chest pain. In cases of trauma, cocaine use was

significantly associated with more frequent requests for blood tests (P < .05), whereas no differences in the use of health care resources for chest pain patients were observed. Conclusions: There is a high prevalence of undisclosed cocaine use among patients attending an emergency department in relation to cardiovascular complaints or trauma. When cocaine use is not the direct reason for the patient’s visit, it does not appear to lead to a marked variation in health care costs during the acute phase of emergency treatment.

Borreguero León JM, Burillo-Putze G, Cinesi Gómez C, De Vera González AM, Fernández Rodríguez JF, García Dopico JA, Jiménez Sosa A, Vallbona Afonso E, Vega Prieto MJ