Caliskan F T, Toker I, Toktas R, Temizyurek Z, Unek O, Zirek B, Karcioglu O
Department of Emergency Medicine, Tepecik Training and Research Hospital; Toxicology Doctorate Program, Dokuzeylül University, Izmir, Turkey.
Department of Emergency Medicine, Tepecik Training and Research Hospital, Izmir, Turkey.
Niger J Clin Pract. 2018 Jan;21(1):99-106. doi: 10.4103/njcp.njcp_227_16.
Country-specific numbers of street drug (SD) users are well documented. However, little data exists regarding these patients' clinical presentations and outcomes in the emergency department (ED). Therefore, management of these patients in the emergency setting is still a subject of debate.
The aim of this study is to determine the symptoms and signs of SD users presenting to the ED, and to report the substances, treatments, and outcomes.
In this single-center study, symptoms, clinical findings, diagnoses, and outcomes of patients who reported to have used SDs or were diagnosed as SD users were investigated within a 1-year study period. Chi-square and Mann-Whitney U tests were performed to compare independent variables.
Mean age of the 425 study patients was 25 ± 9 years (range: 12-64 years), and 6.1% (n = 26) of the patients were females. SDs used before presentation to the ED were mostly synthetic cannabinoids and "ecstasy." Overall prevalence of SD user admissions in ED was 0.24%. The most common presenting complaint was weakness/faintness in 21.1% (n = 90). Depressed level of consciousness was the most common physical sign (33.3%, n = 142). Incidences of altered mental status were significantly higher among ecstasy and/or bonsai users (n = 14, 27.5%; P = 0.027 and n = 46, 64.8%; P < 0.001, respectively), compared to other SD users. While 23.1% (n = 98) of the SD users did not warrant any medical intervention, 6.6% of the users (n = 28) underwent advanced life support.
Self-reported SD users were mostly young males who were treated symptomatically and discharged. Almost one-third-mostly ecstasy and bonsai users-had depressed level of consciousness and required resuscitation.
各国街头毒品（SD）使用者的数量有充分记录。然而，关于这些患者在急诊科（ED）的临床表现和治疗结果的数据却很少。因此，在急诊环境中对这些患者的管理仍是一个有争议的话题。
本研究的目的是确定到急诊科就诊的SD使用者的症状和体征，并报告所使用的物质、治疗方法及治疗结果。
在这项单中心研究中，对在1年研究期间报告使用过SD或被诊断为SD使用者的患者的症状、临床检查结果、诊断及治疗结果进行了调查。采用卡方检验和曼-惠特尼U检验来比较自变量。
425名研究患者的平均年龄为25±9岁（范围：12 - 64岁），6.1%（n = 26）为女性。就诊前使用的SD主要是合成大麻素和“摇头丸”。SD使用者在急诊科住院的总体患病率为0.24%。最常见的就诊主诉是虚弱/头晕，占21.1%（n = 90）。意识水平降低是最常见的体征（33.3%，n = 142）。与其他SD使用者相比，摇头丸和/或盆栽大麻使用者的精神状态改变发生率显著更高（分别为n = 14，27.5%；P = 0.027和n = 46，64.8%；P < 0.001）。虽然23.1%（n = 98）的SD使用者无需任何医疗干预，但6.6%的使用者（n = 28）接受了高级生命支持。
自我报告的SD使用者大多为年轻男性，接受了对症治疗并出院。几乎三分之一的使用者——主要是摇头丸和盆栽大麻使用者——意识水平降低，需要进行复苏。
