Citation

Moritz F, Goullé JP, Girault C, Clarot F, Droy JM, Muller JM. Intensive Care Med. 1999; 25(8): 852-854.

Affiliation

Medical Emergency Department, Hôpital Charles Nicolle, Centre Hospitalier Universitaire, 1 rue de Germont, F-76 031 Rouen Cedex, France. Fabienne.Moritz@chu-rouen.fr

Copyright

(Copyright © 1999, Holtzbrinck Springer Nature Publishing Group)

DOI

unavailable

PMID

10447545

Abstract

OBJECTIVE: To assess the toxicological etiologies in agitated patients and to evaluate their initial clinical diagnosis in the light of toxicological results analysis. DESIGN: Prospective clinical study. SETTING: Emergency Department (ED) in a 2,650-bed University Hospital. PATIENTS: Fifty-eight consecutively enrolled patients admitted to the ED in agitated states over a 6-month period. MEASUREMENTS AND RESULTS: All patients underwent laboratory tests including blood glucose, ethanol and serum drug screening. Toxicology tests were conducted by fluorescence polarization immunoassay and confirmed by high performance liquid chromatography/diode array detector and gas chromatography-mass spectrometry. The physician's initial diagnosis was evaluated in the light of toxicological analysis results. Serum toxicological analysis revealed that 50/58 patients were under the influence of alcohol and/or a drug. Benzodiazepines (22/58), selective serotonin reuptake inhibitors (5/58) and opiates (4/58) were the most frequently observed. The initial clinical diagnosis was alcohol intoxication in 39 patients, although 1 patient was not under the influence of alcohol and 16 also had benzodiazepine in their sera. Moreover, the diagnosis of serotonin syndrome was overlooked in two patients. CONCLUSION: Most agitated patients were under the influence of alcohol and/or a drug. Benzodiazepine alone or in association with alcohol was surprisingly frequent. A serotonin syndrome may explain the agitation state.

Language: en