의도적인 중독 환자들의 음주 여부에 따른 중독 중증도 지수의 비교
Comparison of Poisoning Severity Score (PSS) according to alcohol co-ingestion in intentional poisoning patients
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Alcohol ingestion enhances impulsivity and aggression, and has been proven to have a close relationship with suicide. This study investigates whether alcohol co-ingestion affects the Poisoning Severity Score (PSS) grade in patients with intentional poisoning. Methods: We conducted a retrospective analysis of intentional poisoning patients who visited the emergency department (ED) from January 1 to December 31, 2020. Patients were divided into non-drunken and drunken groups. We collected the data based on the medical records of the patients and serum ethanol level results recorded during initial blood tests at the ED. To grade the PSS, the highest score was assessed through clinical signs and test results during the hospital stay. A comparative analysis was conducted between the two groups. Results: A total of 277 patients were included in the study. 163 (58.8%) were in the non-drunken group, and 114 (41.2%) were in the drunken group. The PSS grade showed a significant difference between the two groups (p=0.002). While grade 1 (mild) was observed more in the non-drunken group, grade 2 (moderate) and grade 3 (severe) were seen more in the drunken group. In an ordinal logistic regression analysis, alcohol co-ingestion (adjusted odds ratio [aOR] 2.557, 95% confidence interval [CI] 1.554- 4.208, p<0.001) was considered to be a risk factor for a higher PSS grade. There was no significant correlation between the serum ethanol level and the PSS grade. (p=0.568) Conclusion: Intentional poisoning patients with alcohol co-ingestion had a higher PSS. Hence close observation and aggressive treatment in the ED is warranted in such cases.
Abstract
Purpose: Alcohol ingestion enhances impulsivity and aggression, and has been proven to have a close relationship with suicide. This study investigates whether alcohol co-ingestion affects the Poisoning Severity Score (PSS) grade in patients with intentional poisoning. Methods: We conducted a retrospective analysis of intentional poisoning patients who visited the emergency department (ED) from January 1 to December 31, 2020. Patients were divided into non-drunken and drunken groups. We collected the data based on the medical records of the patients and serum ethanol level results recorded during initial blood tests at the ED. To grade the PSS, the highest score was assessed through clinical signs and test results during the hospital stay. A comparative analysis was conducted between the two groups. Results: A total of 277 patients were included in the study. 163 (58.8%) were in the non-drunken group, and 114 (41.2%) were in the drunken group. The PSS grade showed a significant difference between the two groups (p=0.002). While grade 1 (mild) was observed more in the non-drunken group, grade 2 (moderate) and grade 3 (severe) were seen more in the drunken group. In an ordinal logistic regression analysis, alcohol co-ingestion (adjusted odds ratio [aOR] 2.557, 95% confidence interval [CI] 1.554- 4.208, p<0.001) was considered to be a risk factor for a higher PSS grade. There was no significant correlation between the serum ethanol level and the PSS grade. (p=0.568) Conclusion: Intentional poisoning patients with alcohol co-ingestion had a higher PSS. Hence close observation and aggressive treatment in the ED is warranted in such cases.
참고문헌 (22)
- "Home/Newsroom/Fact sheets/Suicide"[URL]
- "Home/Data/Suicide rate"[URL]
- "monitoring by Korea Government"[URL]
- Kim B, "Characteristics of methods of suicide attempts in Korea : Korea National Suicide Survey(KNSS)", J Affect Disord, 188, pp.218~225 (2015)
- McCarthy DM, "Acute alcohol effects on impulsivity : associations with drinking and driving behavior", Addiction, 107, pp.2109~2114 (2012)
- Kaplan MS, "Acute alcohol intoxication and suicide : a gender-stratified analysis of the National Violent Death Reporting System", Inj Prev, 19, pp.38~43 (2013)
- Sher L, "Alcohol consumption and suicide", QJM, 99, pp.57~61 (2006)
- Persson HE, "Poisoning Severity Score. Grading of Acute Poisoning", Clin Toxicol, 36, pp.205~213 (1998)
- 정상헌, "중독환자에서 예후 예측 인자로서 중독 중증도 지수의 의의", 대한응급의학회지, 16(6), pp.660~666 (2005), 대한응급의학회
- Cevik AA, "Interrelation between the Poisoning Severity Score, carboxyhaemoglobin levels and in-hospital clinical course of carbon monoxide poisoning", Int J Clin Pract, 60, pp.1558~1564 (2006)
- Volkow ND, "Acute alcohol intoxication decreases glucose metabolism but increases acetate uptake in the human brain", NeuroImage, 64, pp.277~283 (2013)
- Volkow ND, "Effects of acute alcohol intoxication on cerebral blood flow measured with PET", Psychiatry Res, 24, pp.201~209 (1988)
- Gottesmann C, "GABA mechanisms and sleep", Neuroscience, 111, pp.231~239 (2002)
- Lau MA, "Provocation, acute alcohol intoxication, cognitive performance, and aggression", J Abnorm Psychol, 104, pp.150~ (1995)
- Li G, "Alcohol and injury severity : reappraisal of the continuing controversy", J Trauma Acute Care Surg, 42, pp.562~569 (1997)
- Zeckey C, "Alcohol and multiple trauma-is there an influence on the outcome?", Alcohol, 45, pp.245~251 (2011)
- Madan AK, "Alcohol and drug use in victims of life-threatening trauma", J Trauma Acute Care Surg, 47, pp.568~571 (1999)
- Kyoung Sung Yun, "Effect of alcohol intake on the severity of injuries caused by slipping down", Clinical and Experimental Emergency Medicine, 7(3), pp.170~175 (2020), 대한응급의학회[DOI]
- Thompson T, "Analgesic effects of alcohol : a systematic review and meta-analysis of controlled experimental studies in healthy participants", J Pain, 18, pp.499~510 (2017)
- 이운정, "급성 중독 환자의 임상 양상에 알코올 섭취가 미치는 영향", 대한응급의학회지, 20(1), pp.115~121 (2009), 대한응급의학회
- Kaplan MS, "Use of alcohol before suicide in the United States", Ann Epidemiol, 24, pp.588~592 (2014)
- Park CHK, "Impact of acute alcohol consumption on lethality of suicide methods", Compr Psychiatry, 75, pp.27~34 (2017)