Ruttenber A J, Lawler-Heavner J, Yin M, Wetli C V, Hearn W L, Mash D C
Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, USA.
J Forensic Sci. 1997 Jan;42(1):25-31.
We describe an outbreak of deaths from cocaine-induced excited delirium (EDDs) in Dade County, Florida between 1979 and 1990. From a registry of all cocaine-related deaths in Dade County, Florida, from 1969-1990, 58 EDDs were compared with 125 victims of accidental cocaine overdose without excited delirium. Compared with controls, EDDs were more frequently black, male, and younger. They were less likely to have a low body mass index, and more likely to have died in police custody, to have received medical treatment immediately before death, to have survived for a longer period, to have developed hyperthermia, and to have died in summer months. EDDs had concentrations of cocaine and benzoylecgonine in autopsy blood that were similar to those for controls. The epidemiologic findings are most consistent with the hypothesis that chronic cocaine use disrupts dopaminergic function and, when coupled with recent cocaine use, may precipitate agitation, delirium, aberrant thermoregulation, rhabdomyolysis, and sudden death.
我们描述了1979年至1990年间佛罗里达州戴德县因可卡因诱发的兴奋谵妄（EDDs）导致的死亡事件。从佛罗里达州戴德县1969年至1990年所有与可卡因相关的死亡登记中，将58例兴奋谵妄死亡病例与125例无兴奋谵妄的可卡因意外过量受害者进行了比较。与对照组相比，兴奋谵妄患者更常见于黑人、男性且年龄较轻。他们体重指数偏低的可能性较小，更有可能在警方拘留期间死亡，在死亡前立即接受过治疗，存活时间更长，出现过热，且在夏季月份死亡。兴奋谵妄患者尸检血液中的可卡因和苯甲酰爱康宁浓度与对照组相似。这些流行病学发现与以下假设最为一致：长期使用可卡因会破坏多巴胺能功能，当与近期使用可卡因相结合时，可能会引发躁动、谵妄、异常体温调节、横纹肌溶解和猝死。
