Caballero Bellón Marina, Arias Constanti Vanessa, Curcoy Barcenilla Ana I, Trenchs Sainz de la Maza Victoria, Colom Gordillo Anna, Luaces Cubells Carles
Influencia del entorno en el bienestar del niño y del adolescente. Institut de Recerca Sant Joan de Déu. Esplugues de Llobregat. España.
Servicio de Urgencias de Pediatría. Hospital Sant Joan de Déu Barcelona. Esplugues de Llobregat. España.
Rev Esp Salud Publica. 2020 Nov 13;94:e202011129.
A retrospective study (2007-2012) of acute alcohol intoxication (AAI) in the paediatric Emergency Department (ED) (Hospital Sant Joan de Déu, Barcelona) demonstrated a decrease in the rates of AAI over the last two years. Aim: to determine if this decile continued during the following 5 years and to describe the profile and clinical management of these patients.
Descriptive, retrospective and observation study. Adolescents who presented to the ED (Hospital Sant Joan de Déu, Barcelona) with AAI were included (2007-2017). Patients were classified in two groups: mil and moderate/severe; we compared the differences in the clinical management (monitoring of vital signs, lab test and treatment). We defined the AAI incidence rate: number of AAI every 1000 ED adolescent consultations/year.
We included 836 AII, incidence rate: 7.7;2007, 8.5;2008, 6.6;2009, 7.8;2010, 6.4;2011, 6.4;2012, 4.8;2013, 4.6;2014, 5.5;2015, 4.8;2016 and 3.4;2017. The mean age was 15.9 (SD 1.2) years, 54.9% (459) were women. 54.5% had mild AAI, 45.4% moderate/severe. The temperature was taken to 607 patients, capillary blood glucose to 573 and blood pressure to 633. We found no differences in the monitoring of vital signs regardless of the symptoms of the patients. Patients with moderate/severe AAI underwent blood test more frequently than those with mild AAI (ethanol levels 88.2% vs 50.4%; p<0.001; electrolytes 81.2% vs 48%, p<0.001; glucose levels 64.4% vs 37.1%, p<0.001). Four hundred and twelve patients (49.3%) received fluid therapy. Twenty-two patients were admitted.
The incidence of AAI decreased over the last years. The profile of these patients remains unchanged (adolescents with moderate AAI during weekends). Even though lab test were performed more frequently to patients with moderate/severe AAI, clinical management should be improved by taking vital signs and capillary glycemia to all patients, keeping the blood analysis for moderate-severe AAI.
一项对巴塞罗那圣琼·德乌医院儿科急诊科2007年至2012年急性酒精中毒(AAI)情况的回顾性研究表明,过去两年AAI发病率有所下降。目的:确定在接下来的5年中这种下降趋势是否持续,并描述这些患者的特征和临床管理情况。
描述性、回顾性观察研究。纳入在巴塞罗那圣琼·德乌医院急诊科出现AAI的青少年(2007年至2017年)。患者分为两组:轻度和中度/重度;我们比较了临床管理方面的差异(生命体征监测、实验室检查和治疗)。我们定义了AAI发病率:每年每1000次急诊科青少年会诊中的AAI病例数。
我们纳入了836例AAI患者,发病率:2007年为8.5;2008年为6.6;2009年为7.8;2010年为6.4;2011年为6.4;2012年为4.8;2013年为4.6;2014年为5.5;2015年为4.8;2016年为3.4;2017年为3.4。平均年龄为15.9(标准差1.2)岁,54.9%(459例)为女性。54.5%为轻度AAI,45.4%为中度/重度。对607例患者测量了体温,对573例患者测量了毛细血管血糖,对633例患者测量了血压。无论患者症状如何,我们发现生命体征监测方面没有差异。中度/重度AAI患者比轻度AAI患者更频繁地进行血液检查(乙醇水平88.2%对50.4%;p<0.001;电解质81.2%对48%,p<0.001;血糖水平64.4%对37.1%,p<0.001)。412例患者(49.3%)接受了液体治疗。22例患者住院。
过去几年AAI发病率下降。这些患者的特征保持不变(周末出现中度AAI的青少年)。尽管中度/重度AAI患者更频繁地进行实验室检查,但应通过对所有患者测量生命体征和毛细血管血糖来改善临床管理,对中度至重度AAI患者进行血液分析。