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Vallecillo Sánchez G, Chen Quin J, Losada Parente A, Ochoa S, Smithson Amat A, Anaya S, Saubi Roca N, Supervía Caparrós A, Perello Carbonell R. Street drugs associated with acute poisoning: description and analysis of differences in women attended in a hospital emergency department. Emergencias 2024; 36:104-108. [PMID: 38597617 DOI: 10.55633/s3me/025.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The prevalence of street drug abuse is difficult to establish in women because of stigma associated with the practice. The main objective of this study was to analyze possible differences between men and women in a sample of patients attended for emergencies due to acute poisonings. The secondary aim was to identify variables associated with severe poisonings defined arbitrarily as requiring intensive care for more than 12 hours after hospital admission. MATERIAL AND METHODS Retrospective study in 2 hospital EDs. We included patients over the age of 18 years attended for street drug poisonings between July 1, 2020, and July 31, 2023. Epidemiologic, clinical, and laboratory variables were analyzed. RESULTS A total of 1032 patients were studied; 191 (18.5%) were women. The mean (SD) age was 35 years, and the prevalences of acute mental illness and HIV infection were high at 32.2% and 35.7%, respectively. Drug use was recreational in most cases (90.9%). Cocaine, alcohol, and methamphetamines were the substances most often used. Multivariate analysis showed that the factors associated with the seriousness of poisoning were age, with an odds ratio (OR) of 1.03 (95% CI, 1.01-1.05; P = .003); HIV (OR, 2.10; 95% CI, 1.29-3.41; P = .003); use of benzodiazepines (OR, 3.48; 95% CI, 2.14-5.66; P .0001); and suicidal ideations (OR, 1.82; 95% CI, 1.25-3.79; P = .004). CONCLUSION Differences in poisoning characteristics in women were found, probably related to the younger ages of men in the sample and their higher frequency of alcohol consumption. Public health policies and campaigns to prevent drug abuse should take gender differences into consideration in order to adapt messages to the target populations.
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Affiliation(s)
- Gabriel Vallecillo Sánchez
- Servicio de Urgencias. Hospital Parc Salut Mar, Barcelona, España. Unidad VIH, Hospital Parc Salut Mar, Barcelona, España
| | | | | | - Sara Ochoa
- Servicio de Urgencias, Hospital Clínic, Barcelona, España
| | | | - Sara Anaya
- Servicio de Urgencias. Hospital Parc Salut Mar, Barcelona, España
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Soriano Rodríguez C, Supervía Caparrós A, Acer Puig M, Villar Del Saz Cano S, Mínguez Maso S. Acute coronary syndrome and distributive shock due to scombroid fish poisoning. Emergencias 2023; 35:477. [PMID: 38116977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Affiliation(s)
| | - August Supervía Caparrós
- Servicio de Urgencias, Hospital del Mar, Barcelona, España. Unidad Funcional de Toxicología, Hospital del Mar, Barcelona, España
| | - Maria Acer Puig
- Servicio de Medicina Intensiva, Hospital del Mar, Barcelona, España
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Ruiz-Carmona C, Llort Pont C, Corcoll Carrasco F, Supervía Caparrós A, Clara Velasco A. Compartment syndrome after intra-arterial methadone injection. Emergencias 2022; 34:325-327. [PMID: 35833778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Carlos Ruiz-Carmona
- Departamento de Cirugía Vascular, Hospital del Mar, Barcelona, España. Departamento de Cirugía, Universitat Autònoma de Barcelona, Barcelona, España
| | - Carme Llort Pont
- Departamento de Cirugía Vascular, Hospital del Mar, Barcelona, España
| | | | | | - Albert Clara Velasco
- Departamento de Cirugía Vascular, Hospital del Mar, Barcelona, España. Departamento de Cirugía, Universitat Autònoma de Barcelona, Barcelona, España. CIBER Cardiovascular, Barcelona, España
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Supervía Caparrós A, Labordeta de la Cal V, Pantaleón Sánchez M, Cirera Lorenzo I. [Gastric foreign body-induced hematemesis in a body packer]. Emergencias 2019; 29:412-415. [PMID: 29188924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- August Supervía Caparrós
- Servicio de Urgencias, Hospital del Mar, Barcelona, España. Universitat Autònoma de Barcelona, España
| | | | | | - Isabel Cirera Lorenzo
- Servicio de Urgencias, Hospital del Mar, Barcelona, España. Universitat Autònoma de Barcelona, España
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Supervía Caparrós A, Salgado García E, Calpe Perarnau X, Galicia Paredes M, García Gibert L, Córdoba Ruiz F, Clemente Rodríguez C, Nogué Xarau S. Immediate and 30 days mortality in digoxin poisoning cases attended in the Hospital Emergency Services of Catalonia, Spain. Emergencias 2019; 31:39-42. [PMID: 30656872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- August Supervía Caparrós
- 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
| | - Emilio Salgado García
- 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
| | - Xavier Calpe Perarnau
- Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España
| | - Miguel Galicia Paredes
- 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
| | - Lidia García Gibert
- 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
| | - Francisca Córdoba Ruiz
- Grup de treball de Toxicologia de la SoCMUE (SoCMUETox), España. Servicio de Urgencias, Hospital Moises Broggi Sant Joan Despí, Barcelona, España
| | | | - Santiago Nogué Xarau
- 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
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Supervía Caparrós A, Pallàs Villaronga O, Clemente Rodríguez C, Aranda Cárdenas MD, Pi-Figueras Valls M, Cirera Lorenzo I. [Characteristics of emergency poisoning cases in elderly versus younger patients]. Emergencias 2017; 29:335-338. [PMID: 29077293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To compare cases of poisoning according to age to detect differences in frequency of visits to the emergency department, patient characteristics, case management, and immediate outcome in terms of related mortality. MATERIAL AND METHODS Descriptive study of a retrospective series of patients who visited a university hospital emergency department for treatment of poisoning between 2009 and 2014. We collected patient characteristics and data related to the event, case management, and poisoning-related death. Patients were grouped according to age (cut-off 65 y). RESULTS Of a total of 3847 poisoning episodes, 341 (8.9%) were in patients aged 65 years or older. The percentage of women among these older patients (61.3%) was greater than among younger patients (36.3%; P<.001). Poisoning was accidental in older patients more often than younger ones (64.4% vs 9.5%, respectively; P<.001), occurred more often in the home (82.1% vs 37%, P<.001), and more often required active treatment (73.3% vs 57.4%; P<.001) and admission to hospital (21.4% vs 7.3%, P<.001). The related mortality rate was also higher in the older patients (2.1% vs 0.1% in younger patients, P<.001). CONCLUSION The percentage of poisonings in patients aged 65 years or older is not negligible. Poisoning in patients of advanced age tends to be accidental and take place in the home. Older patients more often require active treatment and hospital admission; poisoning-related death is more common in older patients than younger ones.
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Affiliation(s)
- August Supervía Caparrós
- Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox). 6Servicio de Geriatría, Hospital Universitario del Mar, Barcelona, España
| | - Oriol Pallàs Villaronga
- Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España. Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España
| | - Carlos Clemente Rodríguez
- Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Servicio de Geriatría, Hospital Universitario del Mar, Barcelona, España
| | - María Dolores Aranda Cárdenas
- Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España. Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España
| | - María Pi-Figueras Valls
- Unitat Funcional de Toxicología, Hospital Universitario del Mar, Barcelona, España. Grup de treball de Toxicologia de la SoCMUE (SoCMUETox). Servicio de Geriatría, Hospital Universitario del Mar, Barcelona, España
| | - Isabel Cirera Lorenzo
- Servicio de Urgencias, Hospital Universitario del Mar, Barcelona, España. Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España
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