Points requiring attention in primary-care settings in the treatment of patients with acute drug intoxication / 日本プライマリ・ケア連合学会誌

Objective: To develop an effective and safe therapeutic strategy, we studied the effect of the clinical characteristics of patients with acute drug intoxication on the duration of hospitalization. <br>Subjects and Methods: The subjects were 89 patients hospitalized for acute drug intoxication. They were divided into two subgroups; the short hospitalization group (duration of hospitalization < 7 days) and the long hospitalization group (duration of hospitalization ≥ 7 days). We compared age, sex, vital signs, drugs, and therapy between the two groups. <br>Results: There were no significant differences in sex or severity of consciousness disturbance between the short- and long-hospitalization groups. Age in the latter group was higher than that in the former, and age was significantly and positively correlated with the duration of hospitalization. Prolongation of hospitalization in patients with Japan Coma Scale (JCS) I or II is associated with psychiatric disease, and in patients with JCSIII, with physical disease. We used direct hemoperfusion (DHP) to treat patients with severe acute drug intoxication. The duration of hospitalization in patients treated by DHP tended to be shorter than those not so treated. <br>Conclusions: The present results suggest that aging is associated with prolongation of hospitalization and the onset of physical disease among patients with acute drug intoxication. When elderly patients with acute drug intoxication are treated in a primary-care setting, the question of whether or not physical diseases are present as complications should be considered. The appropriate use of DHP for the treatment of patients with severe acute drug intoxication requires further study.

A Clinical Analysis of Pneumonia in Acute Drug Intoxication / 결핵및호흡기질환

BACKGROUND: Acute drug intoxication has recently become an important issue in the social and clinical areas. There are various complications associated with acute drug intoxication such as pneumonia, but the process is was not fully understood. The aim of this study was to analyze our cases of pneumonia associated with acute drug intoxication and to determine the associated risk factors. METHOD: Forty four cases out of 237 patients, who were acute drug intoxicated from May 2000 to Feb. 2005, were diagnosed with pneumonia at the Konyang University hospital. These cases were analyzed by a retrospective review of their medical records. RESULTS: The incidence of pneumonia in acute drug intoxication was 18.6%. There was no gender difference in terms of the incidence, but the age group with the highest incidence was in the 5th decade (22.5%) followed by the 7th decade (17.9%). Most common drug of associated with pneumonia was organophosphate insecticides, and the others were herbicides. Suicidal attempts were the most common motive of intoxication. The incidence of pneumonia was increased in old age (beta=0.128, p<0.05). A drowsy or comatous mental status was an independent risk factors of pneumonia (beta=-0.209, p=0.006). A longer hospital duration was also a risk factor for pneumonia (beta=0.361, p<0.001). The intubated state, intensive care unit care and longer duration of admission correlated with the course of pneumonia in acute drug intoxicated patients (p<0.05). The culture study revealed MRSA to be most common pathogen. CONCLUSION: The incidence of pneumonia associated with acute drug intoxication was higher in the older aged patients, those with a decreased initial mental status and a longer hospital duration. The number of days in the intensive care unit and intubation were associated prognostic factors for pneumonia in acute drug intoxication patients.

Clinical observation of acute drug intoxications / 영남의대학술지

Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).