克罗地亚地中海地区一家医疗重症监护病房收治的成年急性中毒患者的临床和人口统计学特征及预后预测因素。

Clinical and demographic features with outcome predictors of adult patients with acute intoxication admitted to a medical intensive care unit in the Mediterranean part of Croatia.

作者信息

Kovacic Vedran, Kvartuc Lukas, Mikacic Marijana, Jerkovic Ivan, Begovic Tanja Ilic, Maras Marina, Nazlic Jurica

机构信息

Internal Medicine Department, Division of Emergency and Intensive Medicine with Clinical Pharmacology and Toxicology, University Hospital of Split, 21000 Split, Croatia.

University of Split School of Medicine, 21000 Split, Croatia.

出版信息

Toxicol Res (Camb). 2023 Jul 3;12(4):626-634. doi: 10.1093/toxres/tfad054. eCollection 2023 Aug.

DOI:10.1093/toxres/tfad054

PMID:37663800

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10470373/

Abstract

BACKGROUND

The objective of the study was to assess the demographics, clinical parameters, and outcome of acute intoxications among adult patients admitted to a medical intensive care unit in southern Croatia.

MATERIALS AND METHODS

An observational retrospective study was conducted over a 1-year period. The subjects were patients admitted to the intensive care unit for acute poisoning.

RESULTS

In all, 81 subjects (32.1% females) aged 43.16 ± 14.77 years were admitted to the intensive care unit because of poisoning (14.97% of the total annual intensive care unit admissions). Psychiatric disorders were previously established in 76.5% participants, and 69.1% of all acute intoxications were classified as suicidal. Non-suicidal subjects differed from suicidal subjects in age (37.36 ± 9.71 vs. 45.75 ± 15.93 years; = 0.009), in pCO2 (6.38 ± 1.78 vs. 5.50 ± 1.26 kPa; = 0.020), in length-of-stay in intensive care unit (median 1.00, interquartile range 1.00 vs. median 2.00, interquartile range 2.00 days; = 0.022), and in length-of-stay in hospital (median 2.00, interquartile range 2.00 vs. median 10.50, interquartile range 15.25 days; < 0.001). Three (3.7%) patients died. Pharmaceutical psychoactive drug intoxications were the most common poisoning cases; of these, diazepam was the most frequent (16.8%), followed by ethanol (9.0%) and alprazolam (7.8%). Benzodiazepines/hypnotics were the most common group (28.7%), followed by antipsychotics (13.2%). Intoxications with more than 1 poison accounted for the largest number of cases (67.9%). The number of toxins was significantly correlated with length-of-stay in the hospital (rho = -0.265; = 0.008), systolic blood pressure (rho = -0.318; = 0.002), and diastolic blood pressure (rho = -0.262; = 0.009). The electrocardiogram was considered abnormal in 50.62% of the cases.

CONCLUSION

Acute intoxicants were most commonly caused by psychiatric pharmaceutical drugs. Multidrug exposure was a typical pattern of acute intoxication.

摘要

背景

本研究的目的是评估克罗地亚南部一家医疗重症监护病房收治的成年急性中毒患者的人口统计学特征、临床参数及预后情况。

材料与方法

进行了为期1年的观察性回顾性研究。研究对象为因急性中毒入住重症监护病房的患者。

结果

共有81名患者（女性占32.1%）因中毒入住重症监护病房，年龄为43.16±14.77岁（占重症监护病房年收治患者总数的14.97%）。76.5%的参与者既往有精神疾病，所有急性中毒事件中69.1%被归类为自杀性中毒。非自杀性中毒患者与自杀性中毒患者在年龄（37.36±9.71岁与45.75±15.93岁；P=0.009）、二氧化碳分压（6.38±1.78kPa与5.50±1.26kPa；P=0.020）、重症监护病房住院时间（中位数1.00，四分位间距1.00天与中位数2.00，四分位间距2.00天；P=0.022）以及住院时间（中位数2.00，四分位间距2.00天与中位数10.50，四分位间距15.25天；P<0.001）方面存在差异。3名（3.7%）患者死亡。精神活性药物中毒是最常见的中毒类型；其中地西泮最为常见（16.8%），其次是乙醇（9.0%）和阿普唑仑（7.8%）。苯二氮䓬类/催眠药是最常见的类别（28.7%），其次是抗精神病药物（13.2%）。多种毒物中毒的病例数最多（67.9%）。毒物数量与住院时间（rho=-0.265；P=0.008）、收缩压（rho=-0.318；P=0.002）和舒张压（rho=-0.262；P=0.009）显著相关。50.62%的病例心电图异常。