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Yoğun Bakım Ünitesinde Takip Edilen Akut İlaç İntoksikasyonları ve Uyuşturucu Madde Kullanımlarının Değerlendirilmesi: Retrospektif, Tek Merkez Analizi

Year 2023, Volume: 6 Issue: 1, 75 - 83, 30.04.2023
https://doi.org/10.36516/jocass.1216712

Abstract

Amaç: İlaç intoksikasyonları ve uyuşturucu madde kullanımları, acil servisler ve Yoğun bakım ünitelerine (YBÜ) hasta kabulünün önemli bir sebebi olmakla birlikte bir halk sağlığı problemidir. Bu çalışmanın amacı, akut ilaç intoksikasyonları ve uyuşturucu madde kullanımlarının demografik ve klinik verilerinin değerlendirilmesidir.
Yöntemler: Ocak 2014 ile Ocak 2020 tarihleri arasında YBÜ’de akut ilaç intoksikasyonları ve uyuşturucu kullanımı nedeniyle takip edilen hastalar retrospektif olarak değerlendirildi.
Bulgular: 168 ilaç intoksikasyonu ve 26 uyuşturucu madde kullanımı olmak üzere 192 hasta çalışmaya dahil edildi. İlaç intoksikasyonlarının %59.5’i kadın ve yaş ortalaması 27.8±8.3 yıl iken uyuşturucu madde kullanımlarının %92.3’ü erkek ve yaş ortalaması 26.5±3.8 yıl idi. Ortalama YBÜ’de kalma süresi ilaç intoksikasyonlarında 2.3±1.2 gün iken, uyuşturucu madde kullanımlarında 2.8±1.9 gün idi. İlaç intoksikasyonları en fazla oranda 17-30 yaş aralığındaydı ve %98.8’i intihar amaçlıydı. İntoksikasyonların büyük kısmı (%61.9) çoklu ilaçlarla en sık da analjezik (%40.4) ve antidepresanlarla (%34.5) meydana geldi. İlaç intoksikasyonlarının mortalite oranı %0.6 ve uyuşturucu madde kullananların mortalitesi %11.5 idi. Uyuşturucu madde kullanımlarında erkek cinsiyet ve Mv gereksinimi anlamlı olarak yüksek iken, taburculuk ve yatış sırasındaki Glaskow koma skalası (GKS) skorları anlamlı olarak düşük idi (p<0.001).
Sonuç: Uyuşturucu madde kullanımlarında mortalite ve klinik tabloların ilaç intoksijkasyonlarına göre daha ağır olmakla birlikte, her iki durumunda önemli bir halk sağlığı problemi olarak ele alınarak etkili politikaların uygulanması gerektiğini düşünüyoruz.

Supporting Institution

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References

  • 1) Dart RC, Bronstein AC, Spyker DA, et al. Poisoning in the United States: 2012 emergency medicine report of the National Poison Data System. Ann Emerg Med. 2015;65(4):416-22. doi: 10.1016/j.annemergmed.2014.11.001
  • 2) Deniz T, Kandiş H, Saygun M, et al. Evaluation of Intoxication Cases Applied to Emergency Department of Kirikkale University Hospital. Düzce Med J. 2009;11(2):15-20.
  • 3) Liisanantti JH, Ohtonen P, Kiviniemi O, et al. Risk factors for prolonged intensive care unit stay and hospital mortality in acute drug-poisoned patients: an evaluation of the physiologic and laboratory parameters on admission. J Crit Care. 2011;26(2):160-5. doi: 10.1016/j.jcrc.2010.08.009
  • 4) Kaydu A, Akıl F, Araç E, et al. Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation. Van Tıp Derg. 2017;24(4):232-7. doi: 10.5505/vtd.2017.44366
  • 5) Oguzturk H, Turtay MG, Pamukcu E, et al. Demographic features of acute drug poisoning admitted to Inonu university hospital in Malatya, Turkey. Sci Res Essays. 2010:5(18):2761-7.
  • 6) Zöhre E, Ayrık C, Bozkurt S, et al. Retrospective analysis of poisoning cases admitted to the emergency medicine. Arch Iran Med. 2015;18(2):117-22.
  • 7) Sorodoc V, Jaba IM, Lionte C, et al. Epidemiology of acute drug poisoning in a tertiary center from Iasi County, Romania. Hum Exp Toxicol. 2011;30(12):1896-903. doi: 10.1177/0960327111403172
  • 8) Singh O, Javeri Y, Juneja D, et al. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth. 2011;55(4):370-4. doi: 10.4103/0019-5049.84860
  • 9) Özhasenekler RA, Karaman H, Kavak GÖ, et al. Demographical features of patients with suicidal drug intoxication, glasgow coma scale and revised trauma score relationship with mortality. JAEM. 2012;11:200-3. doi:10.5152/jaem.2012.006
  • 10) Doğan E, Ersel M. Evaluation of the Drug Intoxication Cases Admitted to an Emergency Department: Factors Affecting the Outcome and Duration of Stay in the Hospital. EJMI. 2018;2(3):122-8. doi:10.14744/ejmi.2018.85570
  • 11) Kosovalı BD, Yıldız H. Retrospective Evaluation of Four-Year Acute Intoxication Cases Followed-up in Intensive Care Unit. Turk J Intensive Care. 2019;17:75-81. doi: 10.4274/tybd.galenos.2018.04834
  • 12) De Miguel-Bouzas JC, Castro-Tubio E, Bermejo-Barrera AM, et al. Epidemiological study of acute poisoning cases treated at a Galician hospital between 2005 and 2008. Adicciones. 2012;24(3):239-46
  • 13) Khudair IF, Jassim Z, Hanssens Y, et al. Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar. Hum Exp Toxicol. 2013;32(9):921-9. doi: 10.1177/0960327113479043
  • 14) Bronstein AC, Spyker DA, Cantilena LR Jr, et al. 2008 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (Phila). 2009;47(10):911-1084. doi: 10.3109/15563650903438566
  • 15) Lund C, Teige B, Drottning P, et al. A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: epidemiology, intention and follow-up. BMC Public Health. 2012; 12: 858. doi: 10.1186/1471-2458-12-858
  • 16) Caballero Valles PJ, Dorado PS, Diaz BA, et al. Epidemiologic survey of acute poisoning in the south area of the Community of Madrid: the VEIA 2004 study. An Med Interna. 2008; 25(2):67-72. doi: 10.4321/s0212-71992008000200004
  • 17) Yeşiler Fİ, Şendur ÜG, Demiroğlu Gİ. Analysis of Acute Intoxication Cases in Intensive Care Unit. Aegean J Med Sci. 2019;2(1):14-8.
  • 18) Urfalıoğlu A, Dilmen N, Öner SF, et al. Analysis of the Poisoning Cases Admitted in to Intensive Care Unit. İKSST Derg. 2015;7(2):63-8. doi:10.5222/iksst.2015.063
  • 19) Duran M, Uludag O, Yuzkat N. Analysis of adult intoxication cases treated in ICU: A sample from Adıyaman Region of Turkey. MSE. 2016;3(2):71-5. doi:10.17546/msd.41912
  • 20) Ozdemir A, Sen A, Erdivanli Basar, et al. Intoxication in intensive care. J Turgut Ozal Med Cent. 2015; 22(4):218-20. doi: 10.7247/jtomc.2014.2476
  • 21) Köse I, Zincircioğlu Ç, Şenoğlu N, et al. One-year retrospective analysis of poisoning cases admitted to our intensive care unit and evaluation of mortality related factors. Tepecik Eğit. ve Araşt. Hast. Dergisi. 2015;25(1):28-32. doi:10.5222/terh.2015.028
  • 22) Barratt MJ, Cakic V, Lenton S. Patterns of synthetic cannabinoid use in Australia. Drug Alcohol Rev 2013;32(2):141-6. doi: 10.1111/j.1465-3362.2012.00519.x
  • 23) Altınışık U, Altınışık HB, Şimşek T, et al. Yoğun Bakım Ünitesinde Takip Edilen Sentetik Kannabinoid (Bonzai) Zehirlenmesi Olgularının Klinik Özellikleri. Turk J Intensive Care. 2019;17:75-81. doi: 10.4274/tybdd.36025

Evaluation of Acute Drug Intoxications and Drug Use in the Intensive Care Unit: A Retrospective, Single-Center Analysis

Year 2023, Volume: 6 Issue: 1, 75 - 83, 30.04.2023
https://doi.org/10.36516/jocass.1216712

Abstract

Aim: Drug intoxications and drug uses are public health problems and an important reason for patient admission to emergency departments and intensive care units (ICU).This study aims to evaluate the demographic and clinical data of acute drug intoxications and drug use.
Methods: Patients followed up in the ICU for acute drug intoxications and drug use between January 2014 and January 2020 were evaluated retrospectively.
Results: A total of 194 patients were included in the study, including 168 drug intoxication and 26 drug use. While 59.5% of drug intoxications were female, the mean age was 27.8±8.3 years, 92.3% of drug use was male, and the mean age was 26.5±3.8 years. While the mean duration of stay in the ICU was 2.3±1.2 days for drug intoxications, it was 2.8±1.9 days for drug use. The highest rate of drug intoxication was between the ages of 17-30, and 98.8% of them were suicidal. Most of the intoxications (61.9%) occurred with multiple drugs, most commonly with analgesics (40.4%) and antidepressants (34.5%). The mortality rate of drug intoxication was 0.6%, and the mortality rate of drug users was 11.5%. While male gender and mechanical ventilation (Mv) requirement were significantly higher in drug use, Glasgow coma scale (GCS) scores at discharge and hospitalization were significantly lower (p<0.001).
Conclusion: Although mortality and clinical manifestations are more severe in drug use than drug intoxication, we think effective policies should be implemented by considering both cases as significant public health problems.

References

  • 1) Dart RC, Bronstein AC, Spyker DA, et al. Poisoning in the United States: 2012 emergency medicine report of the National Poison Data System. Ann Emerg Med. 2015;65(4):416-22. doi: 10.1016/j.annemergmed.2014.11.001
  • 2) Deniz T, Kandiş H, Saygun M, et al. Evaluation of Intoxication Cases Applied to Emergency Department of Kirikkale University Hospital. Düzce Med J. 2009;11(2):15-20.
  • 3) Liisanantti JH, Ohtonen P, Kiviniemi O, et al. Risk factors for prolonged intensive care unit stay and hospital mortality in acute drug-poisoned patients: an evaluation of the physiologic and laboratory parameters on admission. J Crit Care. 2011;26(2):160-5. doi: 10.1016/j.jcrc.2010.08.009
  • 4) Kaydu A, Akıl F, Araç E, et al. Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation. Van Tıp Derg. 2017;24(4):232-7. doi: 10.5505/vtd.2017.44366
  • 5) Oguzturk H, Turtay MG, Pamukcu E, et al. Demographic features of acute drug poisoning admitted to Inonu university hospital in Malatya, Turkey. Sci Res Essays. 2010:5(18):2761-7.
  • 6) Zöhre E, Ayrık C, Bozkurt S, et al. Retrospective analysis of poisoning cases admitted to the emergency medicine. Arch Iran Med. 2015;18(2):117-22.
  • 7) Sorodoc V, Jaba IM, Lionte C, et al. Epidemiology of acute drug poisoning in a tertiary center from Iasi County, Romania. Hum Exp Toxicol. 2011;30(12):1896-903. doi: 10.1177/0960327111403172
  • 8) Singh O, Javeri Y, Juneja D, et al. Profile and outcome of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J Anaesth. 2011;55(4):370-4. doi: 10.4103/0019-5049.84860
  • 9) Özhasenekler RA, Karaman H, Kavak GÖ, et al. Demographical features of patients with suicidal drug intoxication, glasgow coma scale and revised trauma score relationship with mortality. JAEM. 2012;11:200-3. doi:10.5152/jaem.2012.006
  • 10) Doğan E, Ersel M. Evaluation of the Drug Intoxication Cases Admitted to an Emergency Department: Factors Affecting the Outcome and Duration of Stay in the Hospital. EJMI. 2018;2(3):122-8. doi:10.14744/ejmi.2018.85570
  • 11) Kosovalı BD, Yıldız H. Retrospective Evaluation of Four-Year Acute Intoxication Cases Followed-up in Intensive Care Unit. Turk J Intensive Care. 2019;17:75-81. doi: 10.4274/tybd.galenos.2018.04834
  • 12) De Miguel-Bouzas JC, Castro-Tubio E, Bermejo-Barrera AM, et al. Epidemiological study of acute poisoning cases treated at a Galician hospital between 2005 and 2008. Adicciones. 2012;24(3):239-46
  • 13) Khudair IF, Jassim Z, Hanssens Y, et al. Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar. Hum Exp Toxicol. 2013;32(9):921-9. doi: 10.1177/0960327113479043
  • 14) Bronstein AC, Spyker DA, Cantilena LR Jr, et al. 2008 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (Phila). 2009;47(10):911-1084. doi: 10.3109/15563650903438566
  • 15) Lund C, Teige B, Drottning P, et al. A one-year observational study of all hospitalized and fatal acute poisonings in Oslo: epidemiology, intention and follow-up. BMC Public Health. 2012; 12: 858. doi: 10.1186/1471-2458-12-858
  • 16) Caballero Valles PJ, Dorado PS, Diaz BA, et al. Epidemiologic survey of acute poisoning in the south area of the Community of Madrid: the VEIA 2004 study. An Med Interna. 2008; 25(2):67-72. doi: 10.4321/s0212-71992008000200004
  • 17) Yeşiler Fİ, Şendur ÜG, Demiroğlu Gİ. Analysis of Acute Intoxication Cases in Intensive Care Unit. Aegean J Med Sci. 2019;2(1):14-8.
  • 18) Urfalıoğlu A, Dilmen N, Öner SF, et al. Analysis of the Poisoning Cases Admitted in to Intensive Care Unit. İKSST Derg. 2015;7(2):63-8. doi:10.5222/iksst.2015.063
  • 19) Duran M, Uludag O, Yuzkat N. Analysis of adult intoxication cases treated in ICU: A sample from Adıyaman Region of Turkey. MSE. 2016;3(2):71-5. doi:10.17546/msd.41912
  • 20) Ozdemir A, Sen A, Erdivanli Basar, et al. Intoxication in intensive care. J Turgut Ozal Med Cent. 2015; 22(4):218-20. doi: 10.7247/jtomc.2014.2476
  • 21) Köse I, Zincircioğlu Ç, Şenoğlu N, et al. One-year retrospective analysis of poisoning cases admitted to our intensive care unit and evaluation of mortality related factors. Tepecik Eğit. ve Araşt. Hast. Dergisi. 2015;25(1):28-32. doi:10.5222/terh.2015.028
  • 22) Barratt MJ, Cakic V, Lenton S. Patterns of synthetic cannabinoid use in Australia. Drug Alcohol Rev 2013;32(2):141-6. doi: 10.1111/j.1465-3362.2012.00519.x
  • 23) Altınışık U, Altınışık HB, Şimşek T, et al. Yoğun Bakım Ünitesinde Takip Edilen Sentetik Kannabinoid (Bonzai) Zehirlenmesi Olgularının Klinik Özellikleri. Turk J Intensive Care. 2019;17:75-81. doi: 10.4274/tybdd.36025
There are 23 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Articles
Authors

Kadir Arslan 0000-0003-4061-0746

Ayça Sultan Şahin 0000-0002-7765-5297

Publication Date April 30, 2023
Acceptance Date January 8, 2023
Published in Issue Year 2023 Volume: 6 Issue: 1

Cite

APA Arslan, K., & Şahin, A. S. (2023). Evaluation of Acute Drug Intoxications and Drug Use in the Intensive Care Unit: A Retrospective, Single-Center Analysis. Journal of Cukurova Anesthesia and Surgical Sciences, 6(1), 75-83. https://doi.org/10.36516/jocass.1216712

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