McCutcheon David, Soderstrom Jessamine, Raghavan Mohan, Oosthuizen Francois, Douglas Bianca, Burrows Sally, Smith Jennifer L, Fatovich Daniel
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, Australia.
School of Medicine, University of Western Australia, Perth, Australia.
Addiction. 2025 May;120(5):1007-1015. doi: 10.1111/add.16765. Epub 2025 Jan 20.
This study aimed to describe clinical features and outcomes of patients presenting to the emergency department with analytically confirmed methamphetamine intoxication, to determine the blood concentration of methamphetamine and to test its association with clinical findings.
The Western Australian Illicit Substance Evaluation (WISE) study is a prospective observational cohort study.
Royal Perth Hospital Emergency Department, Perth, Australia, between 2016 and 2018.
Patients suspected to be intoxicated with a stimulant, hallucinogenic or cannabinoid substance and who required intravenous access or blood tests as part of standard care. Those predominantly alcohol intoxicated, behaviourally disturbed or opioid intoxicated were excluded. The 431 participants with detectable methamphetamine (> 0.001 mg/l) included in this analysis had a mean age of 33.2 (9.4) years and 286/431 (66.4%) were male.
Concentration was reported for methamphetamine and other illicit drugs detected. Univariate associations of symptoms and signs, and physiological and laboratory parameters with methamphetamine concentration were determined and used to develop a multivariable model.
The median concentration of methamphetamine was 0.12 mg/L [Q1,Q3: 0.05, 0.27]. Psychotic symptoms were seen in 265/431 (61.5%) patients and intravenous or intramuscular sedation was required in 280/431 (65.0%). Mean heart rate was elevated at 105.9 (21.5) beats per minute, but other mean or median physiological parameters were within normal limits. A multivariable model showed that methamphetamine concentration was 27% lower in males (P = 0.026), 60% higher in those with palpitations (P = 0.013), 62% higher in those with choreoathetoid movements (P = 0.002) and increased by 1% for each unit (μg/L) increment in creatinine (P = 0.001).
In a cohort of emergency department patients with methamphetamine exposure, a multivariable model inferred a significant association between higher methamphetamine concentration and female sex, the presence of palpitations and choreoathetoid movements and creatinine concentration. The model showed no significant association with agitation, psychotic symptoms or other physiological or clinical parameters.
本研究旨在描述经分析确诊为甲基苯丙胺中毒并前往急诊科就诊的患者的临床特征及预后，测定甲基苯丙胺的血药浓度，并检验其与临床发现的相关性。
西澳大利亚非法药物评估（WISE）研究是一项前瞻性观察性队列研究。
2016年至2018年期间，澳大利亚珀斯皇家珀斯医院急诊科。
疑似使用兴奋剂、致幻剂或大麻类物质中毒且作为标准护理一部分需要静脉通路或血液检查的患者。主要为酒精中毒、行为紊乱或阿片类药物中毒的患者被排除。本分析纳入的431名可检测到甲基苯丙胺（>0.001 mg/l）的参与者的平均年龄为33.2（9.4）岁，其中286/431（66.4%）为男性。
报告所检测到的甲基苯丙胺及其他非法药物的浓度。确定症状体征、生理及实验室参数与甲基苯丙胺浓度的单变量关联，并用于建立多变量模型。
甲基苯丙胺的中位数浓度为0.12 mg/L [Q1,Q3：0.05, 0.27]。265/431（61.5%）的患者出现精神病症状，280/431（65.0%）的患者需要静脉或肌肉注射镇静。平均心率升高至每分钟105.9（21.5）次，但其他平均或中位数生理参数在正常范围内。多变量模型显示，男性的甲基苯丙胺浓度低27%（P = 0.026），有心悸的患者高60%（P = 0.013），有舞蹈样动作的患者高62%（P = 0.002），肌酐每增加一个单位（μg/L），甲基苯丙胺浓度增加1%（P = 0.001）。
在一组有甲基苯丙胺暴露史的急诊科患者中，多变量模型推断甲基苯丙胺浓度较高与女性、心悸、舞蹈样动作及肌酐浓度之间存在显著关联。该模型显示与躁动、精神病症状或其他生理或临床参数无显著关联。
