- Analysis of Factors Affecting the Hospitalization of Patients Visited the Emergency Department after Deliberate Self-poisoning
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Woo Sik Noh, Hye Jin Kim
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J Korean Soc Clin Toxicol. 2020;18(2):102-109. Published online December 31, 2020
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DOI: https://doi.org/10.22537/jksct.2020.18.2.102
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Abstract
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- Purpose: This study examined factors associated with the hospitalization of patients who visited the emergency department (ED) after deliberate self-poisoning. Methods: The medical records of the patients, who visited the ED at a tertiary teaching hospital after deliberate self-poisoning between March 2017 and December 2019, were reviewed retrospectively. Results: Fifty-seven in the hospitalization and 236 in the discharge group patients were included. The mean age in the hospitalization and discharge group was 48.8±20.4 and 41.8±19.1, respectively (p=0.020). Univariate analysis revealed statistically significant differences in age (p=0.020), mental status (p<0.001), request for help (p=0.046), chronic disease (p=0.036), substance ingested (p<0.001), and risk rescue-rating scale (p<0.001) between the two groups (hospitalization group and discharge group). In multiple logistic regression analysis for predicting the hospitalization of patients after deliberate self-poisoning, the Risk-Rescue Rating Scale (RRRS) was identified (OR=1.493, 95% confidential interval=1.330-1.675, p<0.001). Receiver operating characteristics analysis of RRRS for the decision to hospitalize showed a cut-off value of 38.9, with a sensitivity, specificity, and area under the curve of 96.4%, 77.0%, and 0.949, respectively. Conclusion: The RRRS can be used to determine the hospitalization for patients who visited the ED after deliberate self-poisoning. Nevertheless, multicenter prospective studies will be needed to determine the generalisability of these results.
- Neutrophil-to-lymphocyte Ratio as A Predictor of Aspiration Pneumonia in Drug Intoxication Patients
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Jeong Beom Lee, Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho, Beom Sok Seo
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J Korean Soc Clin Toxicol. 2018;16(2):61-67. Published online December 31, 2018
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DOI: https://doi.org/10.22537/jksct.2018.16.2.61
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Abstract
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- Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${
ho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${
ho}=0.195$) and between NLR and length of ICU admission (${
ho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).
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