Trauma Under the Influence: A Cross-Sectional Registry Audit of Drug and Alcohol-Related Major Trauma in North Queensland.

OBJECTIVE: Alcohol and drug use is an established factor contributing to traumatic injury globally, yet regional and remote prevalence and impact are poorly characterised. This study examines associations between alcohol and drug use and clinical outcomes among major trauma patients in North Queensland. METHODS: A retrospective audit of major trauma patients in Townsville University Hospital Trauma Registry between October 2022-2023. Patients were classified by alcohol and drug use based on toxicology results and electronic medical record. Demographic, injury and outcome variables were compared using descriptive and non-parametric analysis. RESULTS: Of 319 eligible patients, 110 (34.4%) patients were identified within the alcohol and drug cohort. Alcohol was most frequently detected (82.7%), followed by cannabis (20.0%) and amphetamines (12.7%), with 18.2% demonstrating polysubstance use. Alcohol and/or drug-positive patients were significantly younger (40.7 vs. 49.0 years, p = 0.002) and more likely to sustain assault-related injuries (OR 6.9 (95% CI: 3.1-15.3), p < 0.001). No statistical significance was found between groups for ICU admission rate, ICU LOS or hospital LOS. Discharge and mortality outcomes did not differ between groups. CONCLUSION: This study highlights the impact of alcohol and drug use in regional major trauma patients. Standardised testing, targeted prevention and tailored clinical pathways may improve outcomes and reduce the burden of alcohol and drug-related trauma. Inconsistent screening practices mean the true prevalence remains uncertain, warranting further research to determine the impact and guide interventions.