From the, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain.
Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Alcohol Clin Exp Res. 2019 Oct;43(10):2179-2186. doi: 10.1111/acer.14166. Epub 2019 Aug 27.
Alcohol or other drug (AOD) intoxication in minors is a public health challenge. We characterized underage patients admitted to an emergency department (ED) with acute, recreational AOD intoxication.
We conducted a 5-year (2012 to 2016) analysis of minors admitted to the only hospital-based pediatric ED in an urban area. Episodes of AOD intoxication were selected using ICD-9-CM diagnostic codes. Sociodemographics, substance use and clinical characteristics, laboratory parameters, and discharge dispositions were collected through the revision of clinical charts.
A total of 266 admissions related to recreational AOD intoxication in 258 patients occurred during the study period. Among the 258 patients, 127 (49.2%) were men, median age 16 years [IQR: 15 to 17 years], and 234 (90.7%) of episodes were alcohol-related. At admission, 202/256 (78.9%) patients had a Glasgow Coma Scale ≥ 13 points, the median systolic and diastolic blood pressure was 109 mmHg (IQR: 101 to 118 mmHg) and 67 mmHg (IQR: 60 to 73 mmHg), respectively, and the median blood glucose level was 112 mg/dl (IQR: 99 to 127 mg/dl). Only 72/258 (27.9%) patients underwent urine screening (22/72 (30.5%) were positive for cannabis), and only 30/258 (11.6%) were tested for blood ethanol (median: 185 mg/dl, IQR: 163 to 240 mg/dl). There was a trend in admissions occurring early in the morning of weekend days, and 249 (96.5%) patients were discharged home the day of admission.
Though the severity of AOD intoxication seems to be mild to moderate, assessment of substance exposure is low and may underestimate polydrug use in underage populations.
未成年人的酒精或其他药物（AOD）中毒是一个公共卫生挑战。我们对因急性娱乐性 AOD 中毒而被送入急诊部（ED）的未成年患者进行了特征描述。
我们对一家城市地区的唯一一家医院附属儿科 ED 进行了为期 5 年（2012 年至 2016 年）的分析。使用 ICD-9-CM 诊断代码选择 AOD 中毒发作。通过修订临床图表收集社会人口统计学、物质使用和临床特征、实验室参数以及出院情况。
在研究期间，共有 258 名患者发生了 266 例与娱乐性 AOD 中毒相关的入院事件。在 258 名患者中，有 127 名（49.2%）为男性，中位年龄 16 岁[IQR：15 至 17 岁]，且 234 例（90.7%）为酒精相关。入院时，256 例中有 202 例（78.9%）格拉斯哥昏迷量表评分≥13 分，中位收缩压和舒张压分别为 109mmHg（IQR：101 至 118mmHg）和 67mmHg（IQR：60 至 73mmHg），中位血糖水平为 112mg/dl（IQR：99 至 127mg/dl）。仅 72/258 例（27.9%）患者接受了尿液筛查（22/72 例（30.5%）检测出大麻阳性），仅 30/258 例（11.6%）接受了血液乙醇检测（中位数：185mg/dl，IQR：163 至 240mg/dl）。周末的清晨有发病高峰的趋势，249 例（96.5%）患者在入院当天出院回家。
尽管 AOD 中毒的严重程度似乎为轻度至中度，但对物质暴露的评估较低，可能低估了未成年人群的多药使用情况。
