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Lipofilik İlaç Zehirlenmesinde Vücut Kitle İndeksinin (VKİ) Prognoza Etkisi

Yıl 2021, Cilt 11, Sayı 5, 600 - 604, 17.09.2021
https://doi.org/10.16899/jcm.910926

Öz

Giriş: Bu çalışmanın amacı, acil servislere başvuran hastalarda vücut kitle indeksinin (VKİ) lipofilik ilaç zehirlenmesinin prognozuna etkisini araştırmaktır. Gereç ve Yöntem: Ocak 2014 - Ağustos 2016 tarihleri arasında lipofilik ilaç zehirlenmesi nedeniyle acil servise başvuran hastaların dosyaları incelendi. Demografik özellikler, alınan ilaçlar, başvuru anında şikayetler ve fizik muayene bulguları kaydedildi. Hastaların vücut kitle indeksi hesaplandı. BMI'lerine göre grup oluşturuldu ve karşılaştırıldı. Bulgular: Çalışmaya 202 hasta dahil edildi. Katılımcıların 75'i (% 37,1) 18-24,9 VKİ aralığında, 127'si (% 62,9) ≥25 idi. VKİ grupları arasında yaş, aktif yakınma, hipertansiyon, koroner arter hastalığı, psikiyatrik hastalık, atriyal fibrilasyon, atropin ihtiyacı, pralidoksim ihtiyacı (PAM), mekanik ventilasyon süresi ve yoğun bakımda kalış süresi açısından istatistiksel olarak anlamlı farklılık gözlendi ( p <0,05). Sonuç: VKİ'si yüksek hastalarda atropin ve PAM ihtiyacı, mekanik ventilasyon süresi ve yoğun bakımda kalış süresinin daha yüksek olduğu görüldü. BMI, lipofilik ilaç intoksikasyonu olan hastaların prognozu için prognostik bir faktör olarak kullanılabilir; ancak bulguyu desteklemek için daha kapsamlı çalışmalara ihtiyaç vardır.

Kaynakça

  • Özköse Z and Ayoĝlu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Human & experimental toxicology 1999; 18: 614-618.
  • Li L and Yang X. The essential element manganese, oxidative stress, and metabolic diseases: links and interactions. Oxidative medicine and cellular longevity 2018; 2018.
  • Mert E, Bilgin N, Erdoğan K, et al. Acil servise başvuran akut zehirlenme olgularinin değerlendirilmesi. J Acad Emerg Med 2006; 4: 14-19.
  • Allard J, Le Guillou D, Begriche K, et al. Drug-induced liver injury in obesity and nonalcoholic fatty liver disease. Advances in pharmacology (San Diego, Calif) 2019; 85: 75-107.
  • Gómez-Ambrosi J, Silva C, Galofré J, et al. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. International journal of obesity 2012; 36: 286-294.
  • Kayıpmaz AE, Gülalp B and Benli S. Lipofi lik Ajan Toksisitesinde Yeni Ufuklar. Journal of Academic Emergency Medicine/Akademik Acil Tip Olgu Sunumlari Dergisi 2011; 10.
  • Blanco J, Arévalo F, Correa J, et al. Lipophilic Toxins in Galicia (NW Spain) between 2014 and 2017: Incidence on the Main Molluscan Species and Analysis of the Monitoring Efficiency. Toxins 2019; 11: 612.
  • Cevik SE, Tasyurek T and Guneysel O. Intralipid emulsion treatment as an antidote in lipophilic drug intoxications. The American journal of emergency medicine 2014; 32: 1103-1108.
  • Katzung B. Drugs used in asthma: Basic and Clinical Pharmacology. Florida: Lange 2007: 690.
  • Gunnell D, Eddleston M, Phillips MR, et al. The global distribution of fatal pesticide self-poisoning: systematic review. BMC public health 2007; 7: 357.
  • Lee DH, Jung KY, Choi YH, et al. Body mass index as a prognostic factor in organophosphate-poisoned patients. The American journal of emergency medicine 2014; 32: 693-696.
  • Sasabuchi Y, Yasunaga H, Matsui H, et al. The dose-response relationship between body mass index and mortality in subjects admitted to the ICU with and without mechanical ventilation. Respiratory care 2015; 60: 983-991.
  • Acikalin A, Dişel NR, Matyar S, et al. Prognostic factors determining morbidity and mortality in organophosphate poisoning. Pakistan journal of medical sciences 2017; 33: 534.
  • Yaegashi M, Jean R, Zuriqat M, et al. Outcome of morbid obesity in the intensive care unit. Journal of intensive care medicine 2005; 20: 147-154.
  • O’Brien Jr JM, Philips GS, Ali NA, et al. The association between body mass index, processes of care, and outcomes from mechanical ventilation: a prospective cohort study. Critical care medicine 2012; 40: 1456-1463.
  • O’Brien Jr JM, Phillips GS, Ali NA, et al. Body mass index is independently associated with hospital mortality in mechanically ventilated adults with acute lung injury. Critical care medicine 2006; 34: 738.
  • O'Brien JM, Welsh CH, Fish RH, et al. Excess body weight is not independently associated with outcome in mechanically ventilated patients with acute lung injury. Annals of internal medicine 2004; 140: 338-345.
  • Preljevic VT, Østhus TBH, Sandvik L, et al. Psychiatric disorders, body mass index and C-reactive protein in dialysis patients. General hospital psychiatry 2011; 33: 454-461.
  • Hartwig FP, Bowden J, De Mola CL, et al. Body mass index and psychiatric disorders: a Mendelian randomization study. Scientific reports 2016; 6: 32730.
  • Solmi M, Collantoni E, Meneguzzo P, et al. Network analysis of specific psychopathology and psychiatric symptoms in patients with eating disorders. International Journal of Eating Disorders 2018; 51: 680-692.

Effect Of Body Mass Index (BMI) On The Prognosis In Lipophilic Drug Intoxication

Yıl 2021, Cilt 11, Sayı 5, 600 - 604, 17.09.2021
https://doi.org/10.16899/jcm.910926

Öz

Introduction: The aim of this study was to investigate the effects of body mass index (BMI)c on the prognosis of lipophilic drug intoxication in patients who are admitted to the emergency units. Materials and Methods: The files of the patients who presented to the emergency department with lipophilic drug poisoning between January 2014 and August 2016 were reviewed. Demographic characteristics, medications taken, complaints at the time of admission, and physical examination findings were recorded. BMI of the patients were calculated. The group was created according to their BMI. These groups were compared. Results: 202 patients were included in the study. Among the participants, 75 (37,1%) were in the 18-24,9 BMI interval, and 127 (62,9%) were ≥25. A statistically significant difference was observed between BMI groups regarding age, active complaint, hypertension, coronary artery disease, psychiatric disease, atrial fibrillation, need for atropine, need for pralidoxime (PAM), duration of mechanical ventilation and duration of intensive care unit stay (p<0,05). Conclusions: The need for atropine and PAM, duration of mechanical ventilation and intensive care unit stay were observed to be higher in patients with high BMI. BMI may be used as a prognostic factor for the prognosis of patients with lipophilic drug intoxication; however, more comprehensive studies are needed to support the finding.

Kaynakça

  • Özköse Z and Ayoĝlu F. Etiological and demographical characteristics of acute adult poisoning in Ankara, Turkey. Human & experimental toxicology 1999; 18: 614-618.
  • Li L and Yang X. The essential element manganese, oxidative stress, and metabolic diseases: links and interactions. Oxidative medicine and cellular longevity 2018; 2018.
  • Mert E, Bilgin N, Erdoğan K, et al. Acil servise başvuran akut zehirlenme olgularinin değerlendirilmesi. J Acad Emerg Med 2006; 4: 14-19.
  • Allard J, Le Guillou D, Begriche K, et al. Drug-induced liver injury in obesity and nonalcoholic fatty liver disease. Advances in pharmacology (San Diego, Calif) 2019; 85: 75-107.
  • Gómez-Ambrosi J, Silva C, Galofré J, et al. Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity. International journal of obesity 2012; 36: 286-294.
  • Kayıpmaz AE, Gülalp B and Benli S. Lipofi lik Ajan Toksisitesinde Yeni Ufuklar. Journal of Academic Emergency Medicine/Akademik Acil Tip Olgu Sunumlari Dergisi 2011; 10.
  • Blanco J, Arévalo F, Correa J, et al. Lipophilic Toxins in Galicia (NW Spain) between 2014 and 2017: Incidence on the Main Molluscan Species and Analysis of the Monitoring Efficiency. Toxins 2019; 11: 612.
  • Cevik SE, Tasyurek T and Guneysel O. Intralipid emulsion treatment as an antidote in lipophilic drug intoxications. The American journal of emergency medicine 2014; 32: 1103-1108.
  • Katzung B. Drugs used in asthma: Basic and Clinical Pharmacology. Florida: Lange 2007: 690.
  • Gunnell D, Eddleston M, Phillips MR, et al. The global distribution of fatal pesticide self-poisoning: systematic review. BMC public health 2007; 7: 357.
  • Lee DH, Jung KY, Choi YH, et al. Body mass index as a prognostic factor in organophosphate-poisoned patients. The American journal of emergency medicine 2014; 32: 693-696.
  • Sasabuchi Y, Yasunaga H, Matsui H, et al. The dose-response relationship between body mass index and mortality in subjects admitted to the ICU with and without mechanical ventilation. Respiratory care 2015; 60: 983-991.
  • Acikalin A, Dişel NR, Matyar S, et al. Prognostic factors determining morbidity and mortality in organophosphate poisoning. Pakistan journal of medical sciences 2017; 33: 534.
  • Yaegashi M, Jean R, Zuriqat M, et al. Outcome of morbid obesity in the intensive care unit. Journal of intensive care medicine 2005; 20: 147-154.
  • O’Brien Jr JM, Philips GS, Ali NA, et al. The association between body mass index, processes of care, and outcomes from mechanical ventilation: a prospective cohort study. Critical care medicine 2012; 40: 1456-1463.
  • O’Brien Jr JM, Phillips GS, Ali NA, et al. Body mass index is independently associated with hospital mortality in mechanically ventilated adults with acute lung injury. Critical care medicine 2006; 34: 738.
  • O'Brien JM, Welsh CH, Fish RH, et al. Excess body weight is not independently associated with outcome in mechanically ventilated patients with acute lung injury. Annals of internal medicine 2004; 140: 338-345.
  • Preljevic VT, Østhus TBH, Sandvik L, et al. Psychiatric disorders, body mass index and C-reactive protein in dialysis patients. General hospital psychiatry 2011; 33: 454-461.
  • Hartwig FP, Bowden J, De Mola CL, et al. Body mass index and psychiatric disorders: a Mendelian randomization study. Scientific reports 2016; 6: 32730.
  • Solmi M, Collantoni E, Meneguzzo P, et al. Network analysis of specific psychopathology and psychiatric symptoms in patients with eating disorders. International Journal of Eating Disorders 2018; 51: 680-692.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

İlker KAÇER (Sorumlu Yazar)
TC. Sağlık Bilimleri Üniversitesi Aksaray Eğitim ve Araştırma Hastanesi
0000-0002-9653-7958
Türkiye


Ramazan KÖYLÜ
UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE
0000-0002-7685-8340
Türkiye


Belgin AKILLI
UNIVERSITY OF HEALTH SCIENCES, HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF ACADEMIC EMERGENCY MEDICINE
0000-0001-9329-0964
Türkiye

Yayımlanma Tarihi 17 Eylül 2021
Kabul Tarihi 6 Mayıs 2021
Yayınlandığı Sayı Yıl 2021, Cilt 11, Sayı 5

Kaynak Göster

AMA Kaçer İ. , Köylü R. , Akıllı B. Effect Of Body Mass Index (BMI) On The Prognosis In Lipophilic Drug Intoxication. J Contemp Med. 2021; 11(5): 600-604.