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首页> 外文期刊>journal of pharmaceutical health care and sciences >Relationship between tracheal intubation and the drugs used by patients with drug overdose due to self-harm
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Relationship between tracheal intubation and the drugs used by patients with drug overdose due to self-harm

机译：气管插管与自残用药过量患者用药的关系

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Background Tracheal intubation may be performed in patients with drug overdose due to self-harm; however, the details of the causative drug are unknown. The purpose of this study was to clarify the relationship between drugs or its blood levels of patients with drug overdose and the need for tracheal intubation based on the actual measurement results. Methods From October 2018 to March 2020, 132 patients with drug overdose due to self-harm who were transported to the emergency department (ED) were studied. Patient drugs were measured using gas chromatography-mass spectrometry (GC-MS) and were analyzed on the basis of the GC/MS Forensic Toxicological Database. Logistic analysis was performed by combining patient information and GC-MS information. Results The Glasgow Coma Scale (GCS) and Japan Coma Scale (JCS) efficiently predicted tracheal intubation in patients with drug overdose during transport triage; GCS (cut-off value: 12, area under the curve (AUC): 0.81, 95 confidence interval (CI): 0.71-0.88, sensitivity: 0.85, specificity: 0.71, P < 0.05) and JCS (cut-off value: 3, AUC: 0.74, 95 CI: 0.60-0.84, sensitivity: 0.60, specificity: 0.84, P < 0.05). The drugs detected in all patients with drug overdose in order were benzodiazepine receptor agonists (BZs; 43.9), anticonvulsants (38.6), antipsychotics (25.0), and antidepressants (9.8). In univariate logistic analysis, antipsychotics (odds ratio (OR) 2.46, 95 CI 1.19-5.20, P < 0.05), anticonvulsants (OR 2.71, 95 CI 1.26-5.98, P < 0.05), and anticonvulsants above alert blood levels (OR 27.8, 95 CI 2.92-264.1, P < 0.05) were significantly associated with tracheal intubation in patients with drug overdose, but not BZs and antidepressants. Also, in multivariate logistic analysis, antipsychotics (OR 2.27, 95 CI 1.07-4.83, P < 0.05), anticonvulsants (OR 2.50, 95 CI 1.14-5.64, P < 0.05) and in multivariate logistic analysis of blood levels, anticonvulsants above the alert blood levels (OR 24.9, 95 CI 2.56-241.6, P < 0.05) were significantly associated with tracheal intubation in patients with drug overdose respectively. Conclusions Logistic analysis revealed that the use of anticonvulsants and antipsychotics were significantly associated with an increased OR in the tracheal intubation of patients with drug overdose due to self-harm.
机译：背景 气管插管可用于因自残而药物过量的患者;然而，致病药物的细节尚不清楚。本研究的目的是根据实际测量结果，阐明药物过量患者的药物或其血液水平与气管插管需求之间的关系。方法 选取2018年10月至2020年3月132例因自残导致药物过量转运至急诊科的患者。使用气相色谱-质谱 （GC-MS） 测量患者药物，并在 GC/MS 法医毒理学数据库的基础上进行分析。通过结合患者信息和 GC-MS 信息进行 Logistic 分析。结果 格拉斯哥昏迷量表（GCS）和日本昏迷量表（JCS）在转运分诊过程中有效预测药物过量患者气管插管;GCS（临界值：12，曲线下面积（AUC）：0.81,95%置信区间（CI）：0.71-0.88，灵敏度：0.85，特异性：0.71，P<0.05）和JCS（临界值：3，AUC：0.74,95%CI：0.60-0.84，灵敏度：0.60，特异性：0.84，P<0.05）。在所有药物过量患者中检出的药物依次为苯二氮卓类受体激动剂（BZs;43.9%）、抗惊厥药（38.6%）、抗精神病药（25.0%）和抗抑郁药（9.8%）。在单因素logistic分析中，抗精神病药（比值比（OR）2.46,95%CI 1.19-5.20，P < 0.05），抗惊厥药（OR 2.71,95%CI 1。26-5.98，P < 0.05）和高于警定血水水平（OR 27.8,95% CI 2.92-264.1，P < 0.05）的抗惊厥药与药物过量患者的气管插管显著相关，但 BZ 和抗抑郁药与气管插管无关。此外，在多变量logistic分析中，抗精神病药（OR 2.27,95%CI 1.07-4.83，P < 0.05）、抗惊厥药（OR 2.50,95%CI 1.14-5.64，P < 0.05）和血液水平的多变量logistic分析中，高于警戒血水平（OR 24.9,95%CI 2.56-241.6，P < 0.05）的抗惊厥药分别与药物过量患者的气管插管显著相关。结论 Logistic分析显示，抗惊厥药和抗精神病药的使用与自伤导致药物过量患者气管插管OR增加显著相关。

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