急诊科精神科患者的药物筛查：评估与建议。
Drug screens for psychiatric patients in the emergency department: evaluation and recommendations.
机构信息
Department of Psychiatry, Brigham and Women's Hospital.
出版信息
Psychosomatics. 2013 Jan-Feb;54(1):60-6. doi: 10.1016/j.psym.2012.08.007. Epub 2012 Nov 27.
OBJECTIVE
To better understand how toxicology screening for psychiatric patients in the emergency department (ED) setting affects diagnostic decisions.
METHODS
Retrospective chart review of 439 ED visits of adult patients receiving psychiatry consultations at two hospitals, one an academic medical center (n =224) and the other a community hospital (n = 220), between July 2008 and February 2009. Clinical, demographic, and ED length of stay (LOS) information was abstracted from the psychiatry consultation notes and the medical records.
RESULTS
Positive urine toxicology results, when combined with a basic substance abuse history, were not associated independently with a patient's receiving a substance-related diagnosis as part of the psychiatric assessment. By contrast, a positive blood alcohol level was associated independently with a patient's receiving one of these diagnoses while a positive alcohol use history was not.
CONCLUSIONS
Urine toxicology screens do not add significant diagnostic value to all ED psychiatric evaluations when combined with standard substance use histories.
目的
更好地了解急诊科（ED）中对精神科患者进行毒理学筛查如何影响诊断决策。
方法
对 2008 年 7 月至 2009 年 2 月期间在两家医院（一家为学术医疗中心，n=224；另一家为社区医院，n=220）接受精神科会诊的 439 例成年 ED 就诊患者进行回顾性图表审查。从精神科会诊记录和病历中提取临床、人口统计学和 ED 住院时间（LOS）信息。
结果
阳性尿液毒理学结果与基本的物质滥用史相结合，并不独立与患者接受物质相关诊断作为精神科评估的一部分相关。相比之下，阳性血酒精水平与患者接受这些诊断之一独立相关，而阳性酒精使用史则不然。
结论
当与标准物质使用史相结合时，尿液毒理学筛查并不能为所有 ED 精神科评估增加显著的诊断价值。
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