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

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 [Emergencias 2008;20.380-384]