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Citation
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Reydel T, Callahan JC, Verley L, Teiten C, Andreotti C, Claessens YE, Missud D, L'Her E, Le Roux G, Lerolle N. Am. J. Emerg. Med. 2016; 34(8): 1383-1388. |
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Affiliation
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Angers University, Angers, France; Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France. Electronic address: nicolas.lerolle@univ-angers.fr. |
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Abstract
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CONTEXT: Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied.
MATERIALS AND METHODS: This is a prospective multicentric observational study conducted in the emergency departments and intensive care units of 5 university and nonuniversity French hospitals. Adult self-poisoning patients without severely altered vital status on admission were prospectively included.
RESULTS: Routine biological test (serum electrolytes and creatinine, liver enzymes, bilirubin, blood cell count, prothrombin time) ordering and results were analyzed. A total of 1027 patients were enrolled (age, 40.2 ± 14 years; women, 61.5%); no patient died during the hospital stay. Benzodiazepine was suspected in more than 70% of cases; 65% (range, 48%-80%) of patients had at least 1 routine biological test performed. At least 1 abnormal test was registered in 23% of these patients. Three factors were associated with abnormal test results: age older than 40 years, male sex, and poisoning with a drug known to alter routine tests (ie, acetaminophen, NSAIDs, metformine, lithium). Depending on these factors, abnormal results ranged from 14% to 48%. Unexpected severe life-threatening conditions were recorded in 6 patients. Only 3 patients were referred to the intensive care unit solely because of abnormal test results.
CONCLUSION: Routine biological tests are commonly prescribed in nonsevere self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited.
Copyright © 2016 Elsevier Inc. All rights reserved.
Language: en |