Determinants of Admission to Critical Care Following Acute Recreational Drug Toxicity: A Euro-DEN Plus Study-Reference-Cited by-同舟云学术

Determinants of Admission to Critical Care Following Acute Recreational Drug Toxicity: A Euro-DEN Plus Study

Published:2023-09-14 Issue:18 Volume:12 Page:5970
ISSN:2077-0383
Container-title:Journal of Clinical Medicine
language:en
Short-container-title:JCM

Author:

Noseda Roberta¹^ORCID,Franchi Matteo²³^ORCID,Pagnamenta Alberto⁴⁵⁶,Müller Laura¹,Dines Alison M.⁷,Giraudon Isabelle⁸,Heyerdahl Fridtjof⁹¹⁰^ORCID,Eyer Florian¹¹^ORCID,Hovda Knut Erik¹²^ORCID,Liechti Matthias E.¹³^ORCID,Miró Òscar¹⁴,Vallersnes Odd Martin¹⁵¹⁶^ORCID,Yates Christopher¹⁷,Dargan Paul I.⁷¹⁸,Wood David M.⁷¹⁸,Ceschi Alessandro¹⁴¹⁹²⁰^ORCID,

Affiliation:

1. Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland

2. Unit of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy

3. National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, 20126 Milan, Italy

4. Clinical Trial Unit, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland

5. Department of Intensive Care, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland

6. Division of Pneumology, University of Geneva, 1211 Geneva, Switzerland

7. Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London SE1 7EH, UK

8. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 1249-289 Lisbon, Portugal

9. Prehospital Division, Oslo University Hospital, 0424 Oslo, Norway

10. The Norwegian Air Ambulance Foundation, 0184 Oslo, Norway

11. Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany

12. The Norwegian CBRNE Centre of Medicine, Oslo University Hospital, 0450 Oslo, Norway

13. Clinical Pharmacology and Toxicology, University Hospital and University of Basel, 4056 Basel, Switzerland

14. Emergency Department, Hospital Clínic, University of Barcelona, 08036 Catalonia, Spain

15. Department of General Practice, University of Oslo, 0318 Oslo, Norway

16. Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, 0182 Oslo, Norway

17. Emergency Department and Clinical Toxicology Unit, Hospital Universitario Son Espases, 07120 Mallorca, Spain

18. Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London WC2R 2LS, UK

19. Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland

20. Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, 8091 Zurich, Switzerland

Abstract

This study aimed to characterize patients admitted to critical care following Emergency Department (ED) presentation with acute recreational drug toxicity and to identify determinants of admission to critical care. A retrospective multicenter matched case-control study was conducted by the European Drug Emergency Network Plus (Euro-DEN Plus) over the period 2014–2021. The cases were ED presentations with acute recreational drug toxicity admitted to critical care, the controls consisted of ED presentations with acute recreational drug toxicity medically discharged directly from the ED. The potential determinants of admission to critical care were assessed through multivariable conditional stepwise logistic regression analysis and multiple imputation was used to account for the missing data. From 2014 to 2021, 3448 Euro-DEN Plus presentations involved patients admitted to critical care (76.9% males; mean age 33.2 years; SD 10.9 years). Patient age ≥35 years (as compared to ≤18 years) was a determinant of admission to critical care following acute recreational drug toxicity (adjusted odds ratio, aOR, 1.51, 95% confidence interval, CI, 1.15–1.99), along with polydrug use (aOR 1.39, 95% CI 1.22–1.59), ethanol co-ingestion (aOR 1.44, 95% CI 1.26–1.64), and the use of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL, aOR 3.08, 95% CI 2.66–3.57). Conversely, lower odds of admission to critical care were associated with the use of cocaine (aOR 0.85, 95% CI 0.74–0.99), cannabis (aOR 0.44, 95% CI 0.37–0.52), heroin (aOR 0.80, 95% CI 0.69–0.93), and amphetamine (aOR 0.65, 95% CI 0.54–0.78), as was the arrival to the ED during the night (8 p.m.–8 a.m., aOR 0.88, 95% CI 0.79–0.98). These findings, which deserve confirmation and further investigation, could contribute to a more complete understanding of the decision-making process underlying the admission to critical care of patients with acute recreational drug toxicity.

Publisher

MDPI AG

Subject

General Medicine

Link

https://www.mdpi.com/2077-0383/12/18/5970/pdf

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