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由于 COVID-19 而实施封锁对急诊室中出现的醉酒患者的治疗方式的影响。

Impact of Lockdown due to COVID-19 on the Modalities of Intoxicated Patients Presenting to the Emergency Room.

机构信息

Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Egypt.

Clinical Medical Sciences Department, College of Medicine, Dar Al Uloom University, Saudi Arabia.

出版信息

Prehosp Disaster Med. 2021 Apr;36(2):145-162. doi: 10.1017/S1049023X20001533. Epub 2021 Jan 5.

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19) pandemic influences health care facilities world-wide. The flow rate, type, and severity of cases presented to emergency departments varied during the pandemic in comparison to the past years. However, this change has not been well-described among the cases of hospital admission due to toxic exposure.

STUDY OBJECTIVE

Recognition of the pattern of toxic exposure among the cases refereed to Tanta Poison Control Center (TPCC; Tanta, Egypt) during the past five years, and furthermore, exploration of the impact of lockdown due to the COVID-19 pandemic on the pattern of presented cases.

METHODS

The current study is a five-year retrospective, comparative cross-sectional study carried out among acutely intoxicated patients admitted to TPCC during the spring months (March through May) of 2016-2020. A total of 1,916 patients with complete medical records were recruited. The type and manner of toxic exposure, demographic, clinical data, and outcomes were analyzed.

RESULTS

The current study noted that there were delays in time from toxic exposure to emergency services during the lockdown period. This was reflected in significant lower recovery rates (884.8/1,000 population; z = -3.0) and higher death rates (49.4/1,000 population; z = 2.1) despite the marked decrease in the total number of hospital admissions in comparison to the past four years. The lockdown period showed significantly higher phosphides (z = 3.5; χ2 = 34.295; P <.001) and antipsychotics exposure (z = 3.6; χ2 = 21.494; P <.001) than the previous years. However, predominance of female exposure and intentional self-poisoning was maintained over the past five years, including the lockdown.

CONCLUSION

COVID-19-associated lockdown greatly reformed the usual intoxication pattern of the cases admitted to emergency room. Also, it played a role in delaying time of hospital arrival, which was reflected as lower recovery rates and higher death rates.

摘要

引言

2019 年冠状病毒病(COVID-19)大流行影响了全球的医疗保健设施。与过去几年相比,大流行期间急诊部门接诊的病例数量、类型和严重程度有所不同。然而,由于 COVID-19 大流行而实施的封锁措施对因有毒物质暴露而住院的病例情况却没有很好的描述。

研究目的

本研究旨在描述过去五年间在坦塔中毒控制中心(TPCC;坦塔,埃及)就诊的有毒物质暴露病例模式,并探讨 COVID-19 大流行期间封锁措施对就诊病例模式的影响。

方法

这是一项在 2016 年至 2020 年春季(3 月至 5 月)期间进行的五年回顾性、对比性横断面研究。共纳入 1916 例有完整病历的急性中毒患者。分析了有毒物质暴露的类型和方式、人口统计学、临床数据和结局。

结果

本研究发现,在封锁期间,有毒物质暴露到急诊服务的时间出现延迟。这反映在尽管与过去四年相比,总住院人数明显减少,但康复率(884.8/1000 人;z = -3.0)显著降低,死亡率(49.4/1000 人;z = 2.1)较高。与过去几年相比,封锁期间磷化氢(z = 3.5;χ2 = 34.295;P <.001)和抗精神病药物暴露(z = 3.6;χ2 = 21.494;P <.001)显著增加。然而,包括封锁期间,女性暴露和故意自我中毒的比例在过去五年中一直保持较高水平。

结论

与 COVID-19 相关的封锁措施极大地改变了急诊室收治的中毒病例的通常模式。此外,它还导致了到医院就诊时间的延迟,这反映为康复率降低和死亡率升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b78a/7809242/c1ac4318a12a/S1049023X20001533_fig1a.jpg

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