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Master Thesis

Critères prédictifs de transfert en réanimation des patients présentant une intoxication médicamenteuse volontaire admis en service d'urgence (étude REATOX)

Abstract : Introduction: Self drug poisoning (SDP) leads to 1% of emergency department (ED) admission and 5% of patients suffering from SDP are finally transferred to Intensive Care Unit (ICU). Existing prognostic scores are not efficient enough to predict ICU admission in daily practice. Our purpose was to describe ICU transfer risk factors in SDP. Methods: We performed a retrospective and monocentric study from 2008/01/01 to 2010/12/31. All the patients with a CIM 10 diagnosis code related to intoxication were screened. Only those over 18 y/o with a confirmed diagnosis of SDP were included. Clinical and toxicological data were first analyzed with univariate tests. Factors significantly associated with ICU admission were then introduced in a logistic regression model. Results: Among 5292 cases, 2565 were included (62.3% of women). Median age was 40 y/o (28-49). 142 (5.5%) patients were admitted in ICU. Cardiovascular drugs (OR=15,8 ; 7,1-35,7), neuroleptics (OR=2,9 ; 1,7-4,7) and carbamates ingestion (OR=2,1 ; 1,1-4,1) were identified as risk factors for intensive care admission as well as presumed toxic ingested dose (OR=5 ; 2,3-10,5). Clinically, only Glasgow coma scale had a prognosis value (OR=1,5 ; 1,4-1,6). Discussion: Even retrospective, this large cohort study identifies uncommon factors associated with ICU admission in SDP. The Glasgow coma scale, which remains controversial in SDP, seems to be useful. Conclusion: Emergency physicians should focus on drugs classes and Glasgow coma scale to identify SDP patients at risk of ICU admission.
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https://dumas.ccsd.cnrs.fr/dumas-00653279
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Submitted on : Monday, December 19, 2011 - 11:32:05 AM
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  • HAL Id : dumas-00653279, version 1

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Philippe Pommier. Critères prédictifs de transfert en réanimation des patients présentant une intoxication médicamenteuse volontaire admis en service d'urgence (étude REATOX). Médecine humaine et pathologie. 2011. ⟨dumas-00653279⟩

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