A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae
| Autor: | Knut Erik Hovda, Dag Jacobsen, Cathrine Lund, Javad Vahabi, Marianne Lyngra, Birgitte Stiksrud, Ivind Ekeberg, Per Drottning |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Adolescent Cross-sectional study medicine.medical_treatment Antidotes Poison control Critical Care and Intensive Care Medicine Toxicology law.invention law Naloxone medicine Humans Hospital Mortality Mortality Depression (differential diagnoses) Aged Original Research Coma business.industry Norway Poisoning lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 Length of Stay Middle Aged Gastric lavage Intensive care unit Discontinuation Hospitalization Treatment Intensive Care Units Cross-Sectional Studies Treatment Outcome Emergency Medicine Female medicine.symptom business medicine.drug |
| Zdroj: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 20, Iss 1, p 49 (2012) |
| ISSN: | 1757-7241 |
| Popis: | Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years) admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009) in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU). Active treatment was given to 83%, and consisted of supportive therapy (70%), antidote(s) (38%), activated charcoal (16%) and gastric lavage (9%). The most commonly used antidotes were flumazenil (19%), naloxone (17%) and N-acetylcysteine (11%). The rate of treatment-related complications was 2.4% (21/884). Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120) developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%), prolonged QTc interval (6%) and hypotension (5%). Eight patients died (0.8%) and five (0.5%) survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was largely unchanged. However, few patients developed permanent sequelae. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink