Risk factors for prolonged intensive care unit and hospital stay among patients with acute drug overdose in Japan.

50‐tablet rule drug overdose risk factor suicide triage

Journal

Acute medicine & surgery
ISSN: 2052-8817
Titre abrégé: Acute Med Surg
Pays: United States
ID NLM: 101635464

Informations de publication

Date de publication:
Historique:
received: 26 08 2019
accepted: 25 12 2019
entrez: 29 1 2020
pubmed: 29 1 2020
medline: 29 1 2020
Statut: epublish

Résumé

Hospital selection for patients with drug overdose (DOD) is a critical issue. In Tokyo, the 50-tablet rule has been widely utilized by paramedics for triaging patients with DOD given that it shortens the triage time. However, studies have not investigated the utility of such a rule in local cities. The present study aimed to identify prognostic pre- and in-hospital factors among patients with DOD and determine whether the 50-tablet rule benefits local cities. Clinical records of patients with DOD admitted at the University of Tsukuba Hospital (Tsukuba, Japan) between 2013 and 2017 were retrospectively reviewed. A total of 93 patients with DOD were enrolled in this study. Multivariate analysis showed that creatine kinase and C-reactive protein values and the total number of ingested pills were in-hospital risk factors that significantly prolonged intensive care unit (ICU) and hospital stay. Moreover, Glasgow Coma Scale score on admission and the total number of ingested pills were identified as significant pre-hospital risk factors for prolonged ICU and hospital stay. Setting the total number of ingested pills to 50 tablets did not significantly influence ICU and hospital stay. The total number of ingested pills and creatine kinase and C-reactive protein values were identified as predictive factors for prolonged ICU and hospital stay in patients with DOD after admission. Moreover, pre-hospital risk factors included Glasgow Coma Scale score and the total number of ingested pills. However, the 50-tablet rule was determined to be a poor cut-off value for patients with DOD. We presented a subset of our findings at the 46th annual meeting of the Japanese Society for Acute Medicine (Yokohama, Japan) on 20 November 2018.

Identifiants

pubmed: 31988794
doi: 10.1002/ams2.482
pii: AMS2482
pmc: PMC6971431
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e482

Informations de copyright

© 2020 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.

Déclaration de conflit d'intérêts

Approval of the research protocol and informed consent: This study was approved by the research ethics committee of the University of Tsukuba Hospital. The need for informed consent was waived on account of the retrospective study design. Registry and the registration no. of the study/trial: No. H28‐172. Animal studies: N/A. Conflict of interest: None.

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Auteurs

Yuka Okazaki (Y)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Nobutake Shimojo (N)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Yujiro Matsuishi (Y)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Haruhiko Hoshino (H)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Akira Ouchi (A)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Satoru Kawano (S)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Tetsuya Hoshino (T)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Yasuaki Koyama (Y)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Yuki Enomoto (Y)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Yoshiaki Inoue (Y)

Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba Tsukuba Ibaraki Japan.

Classifications MeSH