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İntihar Amaçlı İlaç Alan Hastalarda Kan Laktat Düzeyleri ile Klinik Sonuçlar Arasındaki İlişki: Retrospektif ve Tanımlayıcı Bir Çalışma

Year 2022, Volume: 4 Issue: 2, 35 - 39, 30.08.2022
https://doi.org/10.51262/ejtox.1124940

Abstract

Giriş: Dünya çapında önemli morbidite ve mortaliteye neden olan akut zehirlenme, önlenebilir bir halk sağlığı sorunudur.
Acil durumlarda kritik hastaların değerlendirilmesinde laktat yararlı bir biyobelirteçtir. Bu çalışmada intihar amaçlı ilaç alımı ile acil servise başvuran hastaların mortalite, morbidite ve yoğun bakım yatışlarının başvuru sırasında ölçülen kan laktat düzeyleri ile belirlenip belirlenemeyeceğini araştırmak amaçlanmıştır.
Gereç-Yöntem: Bu tek merkezli retrospektif çalışmaya 1 Ocak 2019 ile 1 Ocak 2020 tarihleri ​​arasında akut zehirlenme nedeniyle acil servise başvuran 18 yaş üstü hastalar dahil edildi. Başvuru sırasında ölçülen kan laktat düzeyleri ile hastanın klinik sonucu arasındaki ilişki incelendi. Normal dağılan verilere sahip grupları karşılaştırmak için öğrenci t testi, normal dağılmayan veya sıralı veriler için ki-kare testi kullanıldı. p˂0,05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: 223 hastanın verileri analiz edildi. Ortanca yaş 28, kadın oranı %68,6 idi. En sık alınan ilaçlar %35 ile analjezikler, %33,6 ile diğer ilaçlar, %24,7 ile antidepresanlar ve %22,4 ile diğer psikotroplardır. Hastaların 192'si tedavi sonrası taburcu edildi, 31 hasta servise veya yoğun bakıma alındı ​​ve 3 hasta yoğun bakıma yatıştan sonraki ilk 24 saat içinde öldü. Hastaneye yatış ile ilgili faktörler incelendiğinde erkek cinsiyet, yaş ortalamasının yüksek olması, laktat düzeyinin yüksek olması, analjezik ve diğer psikotrop ilaç alımının yatışla ilişkili olduğu saptandı. Öte yandan yaşlılık (48.00, ±16.70), yüksek laktat seviyeleri (6.77, ±6.52) ve düşük bikarbonat seviyeleri (17.40, ±3.05) mortalite ile ilişkilendirildi.
Sonuç: Acil servise intihar amaçlı ilaç kullanımı nedeniyle başvuran hastalarda, başvuru sırasında ölçülen kan laktatı hem mortalite hem de morbiditeyi öngörmede önemli bir biyobelirteçtir.

Supporting Institution

yok

Project Number

yok

References

  • 1. Senarathna L, Buckley NA, Jayamanna SF, Kelly PJ, Dibley MJ, Dawson AH. Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka. Bull World Health Organ. 2012;90(6):436-443A. doi:10.2471/BLT.11.092114
  • 2. Güloğlu C, Kara IH. Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey. Hum Exp Toxicol. 2005;24(2):49-54. doi:10.1191/0960327105ht499oa
  • 3. B. Maharani and N. Vijayakumari., Profile of poisoning cases in a Tertiary care Hospital, Tamil Nadu, India. J App Pharm Sci. 2013; 3 (01): 091-094.
  • 4. Akköse Ş, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O. 1996- 2004 Yılları Arasındaki Erişkin Zehirlenme Olguları. Uludağ Üniversitesi Tıp Fakültesi Dergisi.2006; 32(1): 25-7
  • 5. Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018;8(8):e021881. Published 2018 Aug 29. doi:10.1136/bmjopen-2018-021881
  • 6. Shah, Shreya M, Pratik D. Asari, and Anand J. Amin. "Clinico-Epidemiological profile of patients presenting with acute poisoning." International Journal of Current Research and Review 2016:8:35.
  • 7. Datta D, Walker C, Gray AJ et al. Arterial lactate levels in an emergency department are associated with mortality: a prospective observational cohort study. Emerg Med J. 2015 Sep;32(9):673-7.
  • 8. Dubose Jr TD. Acidosis and alkalosis. In: Longo, et al, editors. Harrison's principles of internal medicine. New York, NY: McGraw-Hill; 2012. p. 366.
  • 9. Kraut JA, Madias NE. Lactic acidosis. N Engl J Med. 2014;371(24):2309-2319. doi:10.1056/NEJMra1309483
  • 10. Pedersen M, Brandt VS, Holler JG, et al. Lactate level, aetiology and mortality of adult patients in an emergency department: a cohort study. Emerg Med J. 2015 Sep;32(9):678-84
  • 11. Casserly B, Phillips GS, Schorr C, et al. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med. 2015 Mar;43(3):567-73.
  • 12. Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Scand J Trauma Resusc Emerg Med 2011;19:74
  • 13. Blum A, Zoubi AA, Kuria S, Blum N. High serum lactate level may predict death within 24 hours. Open Med (Wars). 2015;10(1):318-322. Published 2015 Jun 11. doi:10.1515/med-2015-0045
  • 14. Bou Chebl R, El Khuri C, Shami A, et al. Serum lactate is an independent predictor of hospital mortality in critically ill patients in the emergency department: a retrospective study. Scand J Trauma Resusc Emerg Med. 2017;25(1):69. Published 2017 Jul 14. doi:10.1186/s13049-017-0415-8
  • 15. Schollin-Borg M, Nordin P, Zetterström H, Johansson J. Blood Lactate Is a Useful Indicator for the Medical Emergency Team. Crit Care Res Pract. 2016;2016:5765202. doi:10.1155/2016/5765202
  • 16. Jansen TC, van Bommel J, Schoonderbeek FJ, et al. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med. 2010;182(6):752-761. doi:10.1164/rccm.200912-1918OC

The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study

Year 2022, Volume: 4 Issue: 2, 35 - 39, 30.08.2022
https://doi.org/10.51262/ejtox.1124940

Abstract

Introduction: Acute poisoning that causes significant morbidity and mortality worldwide is a preventable public health problem. In the evaluation of critically ill patients in emergencies, lactate is a useful biomarker. This study aims to investigate whether the mortality, morbidity, and intensive care hospitalization of patients presenting to the emergency department with drug intake for suicide can be determined by the blood lactate levels measured on admission.
Material-Method: Patients over the age of 18 who presented to the emergency department between 1 January 2019 and 1 January 2020 due to acute poisoning were included in this single-center retrospective study. The relationship between the blood lactate levels measured on admission and the clinical outcome of the patient was examined. The student t-test was used to compare groups with normally distributed data, while the chi-square test was used for non-normally distributed or ordinal data. p˂0.05 was considered statistically significant.
Findings: The data of 223 patients were analyzed. The median age was 28, and the female ratio was 68.6%. The most commonly ingested drugs were analgesics with 35%, other drugs with 33.6%, antidepressants with 24.7%, and other psychotropics with 22.4%. 192 of the patients were discharged following the treatment, 31 patients were admitted to the service or intensive care unit, and 3 patients died within the first 24 hours after the intensive care unit admission. When the factors related to hospitalization were examined, male gender, high mean age, high lactate level, and analgesic and other psychotropic drug intake were found to be related to hospitalization. On the other hand, old age (48.00, ±16.70), high lactate levels (6.77, ±6.52), and low bicarbonate levels (17.40, ±3.05) were associated with mortality.
Conclusion: Blood lactate measured on admission is an important biomarker to predict both mortality and morbidity in patients presenting to the emergency department due to the use of drugs for suicidal purposes.

Project Number

yok

References

  • 1. Senarathna L, Buckley NA, Jayamanna SF, Kelly PJ, Dibley MJ, Dawson AH. Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka. Bull World Health Organ. 2012;90(6):436-443A. doi:10.2471/BLT.11.092114
  • 2. Güloğlu C, Kara IH. Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey. Hum Exp Toxicol. 2005;24(2):49-54. doi:10.1191/0960327105ht499oa
  • 3. B. Maharani and N. Vijayakumari., Profile of poisoning cases in a Tertiary care Hospital, Tamil Nadu, India. J App Pharm Sci. 2013; 3 (01): 091-094.
  • 4. Akköse Ş, Köksal Ö, Fedakar R, Emircan Ş, Durmuş O. 1996- 2004 Yılları Arasındaki Erişkin Zehirlenme Olguları. Uludağ Üniversitesi Tıp Fakültesi Dergisi.2006; 32(1): 25-7
  • 5. Zhang Y, Yu B, Wang N, Li T. Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016. BMJ Open. 2018;8(8):e021881. Published 2018 Aug 29. doi:10.1136/bmjopen-2018-021881
  • 6. Shah, Shreya M, Pratik D. Asari, and Anand J. Amin. "Clinico-Epidemiological profile of patients presenting with acute poisoning." International Journal of Current Research and Review 2016:8:35.
  • 7. Datta D, Walker C, Gray AJ et al. Arterial lactate levels in an emergency department are associated with mortality: a prospective observational cohort study. Emerg Med J. 2015 Sep;32(9):673-7.
  • 8. Dubose Jr TD. Acidosis and alkalosis. In: Longo, et al, editors. Harrison's principles of internal medicine. New York, NY: McGraw-Hill; 2012. p. 366.
  • 9. Kraut JA, Madias NE. Lactic acidosis. N Engl J Med. 2014;371(24):2309-2319. doi:10.1056/NEJMra1309483
  • 10. Pedersen M, Brandt VS, Holler JG, et al. Lactate level, aetiology and mortality of adult patients in an emergency department: a cohort study. Emerg Med J. 2015 Sep;32(9):678-84
  • 11. Casserly B, Phillips GS, Schorr C, et al. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Crit Care Med. 2015 Mar;43(3):567-73.
  • 12. Kruse O, Grunnet N, Barfod C. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: a systematic review. Scand J Trauma Resusc Emerg Med 2011;19:74
  • 13. Blum A, Zoubi AA, Kuria S, Blum N. High serum lactate level may predict death within 24 hours. Open Med (Wars). 2015;10(1):318-322. Published 2015 Jun 11. doi:10.1515/med-2015-0045
  • 14. Bou Chebl R, El Khuri C, Shami A, et al. Serum lactate is an independent predictor of hospital mortality in critically ill patients in the emergency department: a retrospective study. Scand J Trauma Resusc Emerg Med. 2017;25(1):69. Published 2017 Jul 14. doi:10.1186/s13049-017-0415-8
  • 15. Schollin-Borg M, Nordin P, Zetterström H, Johansson J. Blood Lactate Is a Useful Indicator for the Medical Emergency Team. Crit Care Res Pract. 2016;2016:5765202. doi:10.1155/2016/5765202
  • 16. Jansen TC, van Bommel J, Schoonderbeek FJ, et al. Early lactate-guided therapy in intensive care unit patients: a multicenter, open-label, randomized controlled trial. Am J Respir Crit Care Med. 2010;182(6):752-761. doi:10.1164/rccm.200912-1918OC
There are 16 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Original Articles
Authors

Birdal Güllüpınar 0000-0002-6657-5654

Caner Sağlam 0000-0002-9967-4456

Erden Erol Ünlüer 0000-0003-0334-7440

Project Number yok
Publication Date August 30, 2022
Submission Date June 2, 2022
Published in Issue Year 2022 Volume: 4 Issue: 2

Cite

APA Güllüpınar, B., Sağlam, C., & Ünlüer, E. E. (2022). The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study. Eurasian Journal of Toxicology, 4(2), 35-39. https://doi.org/10.51262/ejtox.1124940
AMA Güllüpınar B, Sağlam C, Ünlüer EE. The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study. Eurasian J Tox. August 2022;4(2):35-39. doi:10.51262/ejtox.1124940
Chicago Güllüpınar, Birdal, Caner Sağlam, and Erden Erol Ünlüer. “The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study”. Eurasian Journal of Toxicology 4, no. 2 (August 2022): 35-39. https://doi.org/10.51262/ejtox.1124940.
EndNote Güllüpınar B, Sağlam C, Ünlüer EE (August 1, 2022) The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study. Eurasian Journal of Toxicology 4 2 35–39.
IEEE B. Güllüpınar, C. Sağlam, and E. E. Ünlüer, “The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study”, Eurasian J Tox, vol. 4, no. 2, pp. 35–39, 2022, doi: 10.51262/ejtox.1124940.
ISNAD Güllüpınar, Birdal et al. “The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study”. Eurasian Journal of Toxicology 4/2 (August 2022), 35-39. https://doi.org/10.51262/ejtox.1124940.
JAMA Güllüpınar B, Sağlam C, Ünlüer EE. The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study. Eurasian J Tox. 2022;4:35–39.
MLA Güllüpınar, Birdal et al. “The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study”. Eurasian Journal of Toxicology, vol. 4, no. 2, 2022, pp. 35-39, doi:10.51262/ejtox.1124940.
Vancouver Güllüpınar B, Sağlam C, Ünlüer EE. The Relationship Between Blood Lactate Levels and Clinical Outcomes in Patients Taking Drugs for Suicide: A Retrospective and Descriptive Study. Eurasian J Tox. 2022;4(2):35-9.

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