Lee Moon O, Vivier Patrick M, Diercks Deborah B
Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Brown University, Rhode Island Hospital, Providence, Rhode Island, USA.
J Emerg Med. 2009 Aug;37(2):237-41. doi: 10.1016/j.jemermed.2008.05.024. Epub 2008 Dec 11.
Use of illicit drugs results in an increased risk of morbidity and mortality, which is often seen in the Emergency Department (ED). Chest pain is frequently associated with cocaine and methamphetamine use.
To determine if the self-report of recent cocaine or methamphetamine use is reliable in illicit stimulant drug users who present to the ED with chest pain.
A retrospective review of patients presenting to the ED from July 1, 2004 through June 30, 2006 was undertaken. Inclusion criteria were: age >or= 18 years, chief complaint of chest pain, documented social history of drug abuse, positive urine toxicology screen and myoglobin and troponin levels measured, sent from the ED.
For the 318 patients who met the inclusion criteria, the self-report rate of cocaine or methamphetamine use was 51.8% (95% confidence interval [CI] 0.46-0.57). No difference was found in the self-report rate between users of methamphetamine vs. cocaine (odds ratio [OR] 1.12, 95% CI 0.7-1.7). There also was no difference in the self-report rate by patient age < 50 years compared to patient age >or= 50 years (OR 0.67, 95% CI 0.42-1.08). The self-report rate for males compared to females was not significantly different (OR 0.87, 95% CI 0.54-1.4). Patients who had a positive troponin were not significantly more likely to self-report drug use than patients who did not have a positive troponin (OR 1.1, 95% CI 0.55-2.2).
The self-report rate among cocaine- or methamphetamine-using patients presenting to the ED with chest pain was 51.8%. There seems to be no significant difference in the self-report rate among those who use methamphetamine vs. those who use cocaine, nor by gender, nor stratified by age over 50 years.
使用非法药物会增加发病和死亡风险，这在急诊科（ED）中很常见。胸痛常与使用可卡因和甲基苯丙胺有关。
确定在因胸痛就诊于急诊科的非法兴奋剂使用者中，近期使用可卡因或甲基苯丙胺的自我报告是否可靠。
对2004年7月1日至2006年6月30日期间就诊于急诊科的患者进行回顾性研究。纳入标准为：年龄≥18岁，主诉胸痛，有记录的药物滥用社会史，尿液毒理学筛查阳性，且从急诊科送检了肌红蛋白和肌钙蛋白水平。
对于符合纳入标准的318例患者，可卡因或甲基苯丙胺使用的自我报告率为51.8%（95%置信区间[CI]0.46 - 0.57）。甲基苯丙胺使用者与可卡因使用者的自我报告率无差异（优势比[OR]1.12，95%CI 0.7 - 1.7）。年龄<50岁的患者与年龄≥50岁的患者相比，自我报告率也无差异（OR 0.67，95%CI 0.42 - 1.08）。男性与女性的自我报告率无显著差异（OR 0.87，95%CI 0.54 - 1.4）。肌钙蛋白阳性的患者自我报告药物使用的可能性并不比肌钙蛋白阴性的患者显著更高（OR 1.1，95%CI 0.55 - 2.2）。
因胸痛就诊于急诊科的可卡因或甲基苯丙胺使用者的自我报告率为51.8%。使用甲基苯丙胺者与使用可卡因者之间、不同性别之间以及按年龄分层在≥50岁者中，自我报告率似乎均无显著差异。
