Clinical Presentations and Predictors of In-Hospital Mortality in Illicit Drug Users in the New Psychoactive Substances (NPS) Endemic Era in Taiwan
Open Access
- 12 July 2022
- Vol. 10 (7), 386
- https://doi.org/10.3390/toxics10070386
Abstract
Predictors of mortality in illicit drug users involving Novel Psychoactive Substances (NPS) and multiple substances have not been elucidated. We aimed to define predictors of mortality in the NPS endemic era’s illicit drug users to strengthen patient care in emergency treatment. This was a retrospective study. LC-MS/MS-confirmed positive illicit drug users who visited the emergency departments (ED) of six medical systems were enrolled. Demographic information, physical examinations, and laboratory data were abstracted for mortality analysis. There were 16 fatalities in 355 enrolled patients. The most frequently used illicit drugs were amphetamines, followed by opioids, cathinones, and ketamine. The most frequently detected cathinones among the 16 synthetic cathinones were eutylone, followed by mephedrone. The combined use of cathinones and ketamine was most commonly observed in our results. Univariate analysis revealed that the mortality patients were older, with deep coma, faster heart rate and respiratory rate, lower blood pressures and O2 room air saturation, more seizures, abnormal breath sounds, and had urine incontinence compared to the survivor patients. The mortality patients also had acute kidney injury, higher potassium, blood sugar, liver function test, and lactate level. The results of multiple logistic regression demonstrated that SBP < 90 mmHg, dyspnea, blood sugar > 140 mg/dl, and HCO3 < 20.6 mmHg were independent predictors of in-hospital mortality. Regardless of the pattern of the use of illicit drugs, the predictors allow for risk stratification and determining the optimal treatment.This publication has 22 references indexed in Scilit:
- Abuse of New Psychoactive Substances: Threats and SolutionsNeuropsychopharmacology, 2015
- [Treatment of intoxication with new psychoactive substances and methamphetamine].2015
- A critical first assessment of the new pre‐market approval regime for new psychoactive substances (NPS) in New ZealandAddiction, 2014
- Stress HyperglycemiaCritical Care Medicine, 2013
- Changing Trends and Predictors of Outcome in Patients with Acute Poisoning Admitted to the Intensive CareJournal of Tropical Pediatrics, 2010
- Metabolic acidosis: pathophysiology, diagnosis and managementNature Reviews Nephrology, 2010
- Features and Prognostic Factors for Elderly With Acute Poisoning in the Emergency DepartmentJournal of the Chinese Medical Association, 2010
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies*Bulletin of the World Health Organization, 2007
- Health care systems in transition. II. Taiwan, Part II. The current status of HIV-AIDS in Taiwan.1998
- Health care systems in transition II. Taiwan, Part II. The current status of HIV-AIDS in TaiwanPublished by Oxford University Press (OUP) ,1998