Acil Servise Sentetik Kannabinoid Kullanımı Sonrası Başvuran Hastaların Tanımlayıcı Epidemiyolojisi

Abstract

Amaç: Sentetik kannabinoid kullanımı sonrası başvuran hastaların bir yıllık dönemde zamansal dağılımını, alımdan başvuruya kadar geçen süreyi, ürün ve ticari isim profilini, çoklu madde kullanımını ve acil servis bakım özelliklerini tanımlamayı amaçladık. Gereç ve Yöntem: Bu retrospektif, kesitsel ve tek merkezli çalışmaya, Temmuz 2014 ile Haziran 2015 tarihleri arasında Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi Acil Servisine sentetik kannabinoid kullanımı bildirilerek başvuran 15–65 yaş arasındaki 140 hasta dahil edildi. Hastaların demografik özellikleri, başvuruların zamansal dağılımı (mevsim, ay, gün ve saat), alımdan başvuruya kadar geçen süre, sorumlu ürün ve ticari isim, çoklu madde kullanımı, kullanım yolu, intravenöz sıvı gereksinimi, acil serviste kalış süresi ve sonlanımları tanımlayıcı olarak değerlendirildi. Bulgular: Hastaların 129'u (%92,1) erkek olup yaş ortalaması 27,2 ± 8,1 yıl idi; 77'si (%55,0) ambulansla getirildi. Başvurular en sık Ocak ve Temmuz aylarında (her biri %14,3), hafta sonlarında (Cumartesi %18,6) ve 16:00–24:00 saatleri arasında (%38,6) gerçekleşti. Hastaların çoğu (%86,5) alımdan sonraki ilk dört saat içinde başvurdu. Olguların %67,1'inde yalnızca sentetik kannabinoid kullanımı mevcutken, %32,9'unda alkol veya başka maddelerle birlikte kullanım saptandı. En sık kullanım yolu elde sarılan sigara (%54,3), en sık bildirilen ticari isim ise Bonzai (%52,1) idi. Tekrarlayan başvuru oranı %10,7 olarak bulundu. Uygulanan ortalama intravenöz sıvı hacmi 2107 ± 1005 mL idi. Hastaların 113'ü (%80,7) taburcu edilirken, 17'si (%12,1) yoğun bakım ünitesine yatırıldı, bir hasta (%0,7) kaybedildi ve 9 hasta (%6,4) tedaviyi reddederek ayrıldı. Sonuç: Sentetik kannabinoid başvuruları belirgin mevsimsel, haftalık ve günlük örüntüler göstermekte; sık çoklu madde kullanımı ve önemli düzeyde acil servis kaynak kullanımı ile karakterize olmakta ve çoğunlukla Bonzai tipi ürünlerle ilişkili bulunmaktadır. Bu epidemiyolojik örüntülerin tanımlanması, acil servis hazırlığı, kaynak planlaması ve halk sağlığı sürveyansına katkı sağlayabilir.

Keywords

• Sentetik kannabinoid
• acil servis
• hastane
• Epidemiyoloji
• Madde kullanım bozuklukları

Thanks

Yazarlar, bu çalışmanın hazırlanma sürecindeki değerli akademik rehberliği ve desteği için Prof. Dr. İbrahim İkizceli'ye teşekkür eder.

Descriptive Epidemiology Of Synthetic Cannabinoid Presentations to the Emergency Department

Abstract

Objective: To describe the temporal distribution, time from intake to presentation, product and trade-name profile, polysubstance use, and emergency department care characteristics of patients presenting after synthetic cannabinoid use over a one-year period. Materials and Methods: This retrospective, cross-sectional, single-centre study included 140 patients aged 15–65 years who presented to the emergency department of Şişli Hamidiye Etfal Training and Research Hospital between July 2014 and June 2015 with reported synthetic cannabinoid use, based on the statements of the patients or their relatives. Demographic characteristics, temporal distribution of presentations (season, month, day and hour), interval from intake to presentation, causative product and trade name, polysubstance use, route of administration, intravenous fluid requirements, length of emergency department stay and patient outcomes were evaluated descriptively. Results: Of the patients, 129 (92.1%) were male, with a mean age of 27.2 ± 8.1 years; 77 (55.0%) arrived by ambulance. Presentations clustered in January and July (14.3% each) and on weekends (Saturday 18.6%), and peaked between 16:00 and 24:00 (38.6%); most patients (86.5%) presented within four hours of intake. Synthetic cannabinoid alone accounted for 67.1% of cases, whereas 32.9% involved alcohol or other drugs. Smoking a hand-rolled cigarette was the most common route of administration (54.3%), and Bonzai was the most frequently reported trade name (52.1%). Repeat presentation occurred in 10.7% of patients. The mean intravenous fluid volume administered was 2107 ± 1005 mL. Overall, 113 patients (80.7%) were discharged, 17 (12.1%) were admitted to intensive care, one (0.7%) died, and 9 (6.4%) left against medical advice. Conclusion: Synthetic cannabinoid presentations cluster in identifiable seasonal, weekly and daily patterns, are characterized by frequent polysubstance use and substantial emergency department resource utilization, and predominantly involve Bonzai-type products. Recognition of these epidemiological patterns may contribute to emergency department preparedness, resource allocation and public-health surveillance strategies.

Keywords

• Synthetic Cannabinoids
• Emergency Service
• Hospital
• Epidemiology
• Substance-related disorders.

Thanks

The authors would like to thank Prof. Dr. İbrahim İkizceli for his valuable academic guidance and support during the development of this study.

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