| Popis: |
Background : Alcohol is one of the most commonly co-ingested agents in acute poisoning patients visiting the emergency department (ED). The aim of this study was to compare the outcomes and clinical features of acute-poisoning patients with and without co-ingestion of alcohol. Methods: We retrospectively investigated poisoning patients who visited in the ED from January 2010 to December 2016 in a single center, Republic of Korea. Patients were classified into two groups: with or without alcohol co-ingestion. Data on clinical variables, outcomes, and poisoning severity score (PSS) were collected and compared. Primary outcomes analyzed were admission to the general ward or intensive care unit (ICU) from ED and discharge against medical advice (AMA). Results: A total of 730 patients were included in the study, with 285 (39.0%) in the alcohol co-ingestion (ALC+) group. The patients who had also co-ingested alcohol, more were male, the peak age distribution was 45-54 years old, more had arrived at the ED at night. The rate of discharge against medical advice (AMA) was higher in the ALC+ group (136; 47.7%) than the ALC- group (p = 0.001). In multivariate analysis of DSP, the absence of alcohol co-ingestion (odds ratio [OR]1.41; 95% confidence interval [CI] 1.01-1.96), poisoning severity score (OR 1.74; 95% CI 1.34-2.27), previous MDD history (OR 1.57; 95% CI 1.13-2.19) and GCS score < 13 (OR 2.09; 95% CI 1.48-2.95) were shown to be independent predictive factors of admission (p = 0.042, p < 0.001, p = 0.008, p < 0.001). Conclusion: Alcohol co-ingestion in poisoning patients was a factor affecting admission to the general ward or ICU in the ED. Therefore, emergency physicians assessing the disposition of poisoning patients should be aware that poisoning patients who have co-ingested alcohol may be uncooperative and be at high risk for the AMA discharge. |
