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. 2018;6(1):e1.
Epub 2018 Jan 10.

Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases

Mitra Rahimi  1 , Somaieh Lookzadeh  1 , Roxana Sadeghi  2 , Kambiz Soltaninejad  3 , Shahin Shadnia  1 , Abdolkarim Pajoumand  1 , Hossein Hassanian-Moghaddam  1 , Nasim Zamani  1 , Masoud Latifi-Pour  1
Affiliations

Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases

Mitra Rahimi et al. Emerg (Tehran). 2018.

Abstract

Introduction: Amphetamine type stimulants (ATS) such as amphetamine and methamphetamine (MA) are one of the most important causes of poisoning in the world. In this study we aimed to define the predictive factors of mortality in acute ATS poisoning patients.

Methods: This is a retrospective cross-sectional study on all cases with acute ATS poisoning who were referred to a referral center for poisoning, Tehran, Iran, from April 2011 to March 2014. Using patients' medical records, demographic data, route of exposure, type and amount of ATS, the cause of poisoning, clinical presentations, and electrocardiogram (ECG) and laboratory findings, as well as patient's outcomes were collected and analyzed regarding the independent predictive factors of mortality.

Results: 226 cases with the mean age of 32.9 ± 10.9 years were studied (77% male). MA was the most abused ATS (97.4%) and the most frequent route of exposure was oral (55.3%). The mortality rate was 5.4%. There was a significant association between agitation (p = 0.002), seizure (p = 0.001), loss of consciousness (p < 0.001), creatine phosphokinase level (p = 0.002), serum pH (p = 0.002), serum HCO3 (p = 0.02), and PCO2 (p = 0.01) with mortality. However, serum HCO3 [OR=1.27 (95% CI: 1.07-1.50); p value=0.005], PCO2 [OR=0.89 (95% CI: 0.84-0.96); p value=0.002], and loss of consciousness [OR=0.019 (95% CI: 0.003-0.106); p value=0.000] were the only independent predictive factors of mortality.

Conclusion: PCO2 ≥ 51 mmHg, serum bicarbonate ≤ 22.6 mEq/L, and loss of consciousness on admission could be considered as prognostic factors of mortality in acute ATS poisoning cases presenting to emergency department.

Keywords: Amphetamines; patient outcome; poisoning; prognostic factors; substance abuse.

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Conflict of interest statement

The authors declare that there is no conflict of interests regarding the publication of this paper.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve for PCO2 and serum HCO3 in predicting the risk of mortality in acute amphetamine Type Stimulants (ATS) intoxicated patients.
Diagram 1
Diagram 1
Flow diagram of patient selection. ATS: Amphetamine Type Stimulants
See this image and copyright information in PMC

References

    1. World Health Organization. Amphetamine-type stimulants. [Available 1 August 2017]. [Available from: www.who.int/substance_abuse/facts/ATS/en/
    1. Kumar MS, Kumar S. Amphetamine type stimulants (ATS) use in India- An exploratory study. New Delhi, India: United Nations Office on Drugs and Crime (UNODC); 2015.
    1. United Nations Office on Drugs and Crime (UNODC) World Drug Report. Vienna: 2015.
    1. United Nations Office on Drugs and Crime (UNODC) The Challenge of Synthetic Drugs in East and South-East Asia and Oceania. Vienna: 2015. May,
    1. Alam Mehrjerdi Z, Noroozi A. Methamphetamine intoxication in emergency departments of hospitals in iran: implications for treatment. Iran J Med Sci. 2013;38(4):347–8. - PMC - PubMed

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