Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain.

Autor:	Supervía Caparrós A; Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España. Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Universitat Autònoma de Barcelona, España. Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España., Salgado García E; Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Hospital Clínic de Barcelona, España. Unidad de Toxicología, Hospital Clínic de Barcelona, España. Universitat de Barcelona, España., Calpe Perarnau X; Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España., Galicia Paredes M; Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Hospital Clínic de Barcelona, España. Unidad de Toxicología, Hospital Clínic de Barcelona, España., García Gibert L; Universitat Autònoma de Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Consorci Sanitari Parc Taulí, Sabadell, Barcelona, España., Córdoba Ruiz F; Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Hospital Moises Broggi Sant Joan Despí, Barcelona, España., Clemente Rodríguez C; Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España., Nogué Xarau S; Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Hospital Clínic de Barcelona, España. Unidad de Toxicología, Hospital Clínic de Barcelona, España. Universitat de Barcelona, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias [Emergencias] 2019 Feb; Vol. 31 (1), pp. 39-42.
Abstrakt:	Objectives: Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning. Material and Methods: Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospitals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored. Results: A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify factors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analysis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with immediate mortality. A lower Barthel index was associated with 30-day mortality. Conclusion: Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index.
Databáze:	MEDLINE
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