Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases
Introduction: Amphetamine type stimulants (ATS) such as amphetamine and methamphetamine (MA) are one of the most important causes of poisoning in the world.  In this study we aimed to define the predictive factors of mortality in acute ATS poisoning patients. Methods: This is a retrospective cro...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2018-11-01
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| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/44 |
| _version_ | 1818510927209693184 |
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| author | Mitra Rahimi Somaieh Lookzadeh Roxana Sadeghi Kambiz Soltaninejad Shahin Shadnia Abdolkarim Pajoumand Hossein Hassanian-Moghaddam Nasim Zamani Masoud Latifi-Pour |
| author_facet | Mitra Rahimi Somaieh Lookzadeh Roxana Sadeghi Kambiz Soltaninejad Shahin Shadnia Abdolkarim Pajoumand Hossein Hassanian-Moghaddam Nasim Zamani Masoud Latifi-Pour |
| author_sort | Mitra Rahimi |
| collection | DOAJ |
| description | Introduction: Amphetamine type stimulants (ATS) such as amphetamine and methamphetamine (MA) are one of the most important causes of poisoning in the world.  In this study we aimed to define the predictive factors of mortality in acute ATS poisoning patients. Methods: This is a retrospective cross-sectional study on all cases with acute ATS poisoning who were referred to a referral center for poisoning, Tehran, Iran, from April 2011 to March 2014. Using patients’ medical records, demographic data, route of exposure, type and amount of ATS, the cause of poisoning, clinical presentations, and electrocardiogram (ECG) and laboratory findings, as well as patient’s outcomes were collected and analyzed regarding the independent predictive factors of mortality. Results: 226 cases with the mean age of 32.9 ± 10.9 years were studied (77% male). MA was the most abused ATS (97.4%) and the most frequent route of exposure was oral (55.3%). The mortality rate was 5.4%. There was a significant association between agitation (p = 0.002), seizure (p = 0.001), loss of consciousness (p < 0.001), creatine phosphokinase level (p = 0.002), serum pH (p = 0.002), serum HCO3 (p = 0.02), and PCO2 (p = 0.01) with mortality. However, serum HCO3 [OR=1.27 (95% CI: 1.07-1.50); p value=0.005], PCO2 [OR=0.89 (95% CI: 0.84-0.96); p value=0.002], and loss of consciousness [OR=0.019 (95% CI: 0.003-0.106); p value=0.000] were the only independent predictive factors of mortality. Conclusion: PCO2 ≥ 51 mmHg, serum bicarbonate ≤ 22.6 mEq/L, and loss of consciousness on admission could be considered as prognostic factors of mortality in acute ATS poisoning cases presenting to emergency department. |
| first_indexed | 2024-12-10T23:26:41Z |
| format | Article |
| id | doaj.art-fc035c6a483e4ab6a7aea12207df68e0 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-12-10T23:26:41Z |
| publishDate | 2018-11-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-fc035c6a483e4ab6a7aea12207df68e02022-12-22T01:29:34ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042018-11-016110.22037/aaem.v6i1.44Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 CasesMitra Rahimi0Somaieh Lookzadeh1Roxana Sadeghi2Kambiz Soltaninejad3Shahin Shadnia4Abdolkarim Pajoumand5Hossein Hassanian-Moghaddam6Nasim Zamani7Masoud Latifi-Pour8Toxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranCardiology Department, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranToxicology Research Center, Excellence Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranIntroduction: Amphetamine type stimulants (ATS) such as amphetamine and methamphetamine (MA) are one of the most important causes of poisoning in the world.  In this study we aimed to define the predictive factors of mortality in acute ATS poisoning patients. Methods: This is a retrospective cross-sectional study on all cases with acute ATS poisoning who were referred to a referral center for poisoning, Tehran, Iran, from April 2011 to March 2014. Using patients’ medical records, demographic data, route of exposure, type and amount of ATS, the cause of poisoning, clinical presentations, and electrocardiogram (ECG) and laboratory findings, as well as patient’s outcomes were collected and analyzed regarding the independent predictive factors of mortality. Results: 226 cases with the mean age of 32.9 ± 10.9 years were studied (77% male). MA was the most abused ATS (97.4%) and the most frequent route of exposure was oral (55.3%). The mortality rate was 5.4%. There was a significant association between agitation (p = 0.002), seizure (p = 0.001), loss of consciousness (p < 0.001), creatine phosphokinase level (p = 0.002), serum pH (p = 0.002), serum HCO3 (p = 0.02), and PCO2 (p = 0.01) with mortality. However, serum HCO3 [OR=1.27 (95% CI: 1.07-1.50); p value=0.005], PCO2 [OR=0.89 (95% CI: 0.84-0.96); p value=0.002], and loss of consciousness [OR=0.019 (95% CI: 0.003-0.106); p value=0.000] were the only independent predictive factors of mortality. Conclusion: PCO2 ≥ 51 mmHg, serum bicarbonate ≤ 22.6 mEq/L, and loss of consciousness on admission could be considered as prognostic factors of mortality in acute ATS poisoning cases presenting to emergency department.https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/44Amphetaminespatient outcomeprognostic factorspoisoningsubstance abuse |
| spellingShingle | Mitra Rahimi Somaieh Lookzadeh Roxana Sadeghi Kambiz Soltaninejad Shahin Shadnia Abdolkarim Pajoumand Hossein Hassanian-Moghaddam Nasim Zamani Masoud Latifi-Pour Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases Archives of Academic Emergency Medicine Amphetamines patient outcome prognostic factors poisoning substance abuse |
| title | Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases |
| title_full | Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases |
| title_fullStr | Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases |
| title_full_unstemmed | Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases |
| title_short | Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases |
| title_sort | predictive factors of mortality in acute amphetamine type stimulants poisoning a review of 226 cases |
| topic | Amphetamines patient outcome prognostic factors poisoning substance abuse |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/44 |
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