Journal of The Korean Society of Clinical Toxicology

Case Report

A case of chronic licorice intoxication-induced apparent mineralocorticoid excess syndrome: Young Jae Lim, Ji Eun Kim; J Korean Soc Clin Toxicol. 2023;21(2):151-155. Published online December 29, 2023; DOI: https://doi.org/10.22537/jksct.2023.00020

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Abstract PDF: Licorice is a perennial herb belonging to the legume family that mainly grows in northeastern China, Mongolia, Siberia, and other regions. It is used in traditional medicine in the form of dried roots in the East and the West. The main active component of licorice, glycyrrhizin, is known to produce mineralocorticoid effects when consumed chronically, which can lead to apparent mineralocorticoid excess syndrome. Herein, we present the case of a 72-year-old woman who was admitted to the emergency room with severe generalized weakness and difficulty keeping her neck upright, which had developed after daily consumption of licorice-infused water for the past 2 months. Blood tests revealed metabolic alkalosis and severe hypokalemia, and an electrocardiogram showed ventricular bigeminy. The patient was treated with daily potassium and spironolactone supplements, leading to a significant improvement in muscle strength after a week. One week later, the patient was discharged, showing rare ventricular premature contractions on electrocardiography, but with no specific complaints. Chronic licorice ingestion leading to hypokalemia and muscle weakness can be life-threatening, necessitating the discontinuation of the causative agent, close monitoring, and cautious supplementation of potassium and spironolactone as treatment.

Original Articles

Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status: Rok Lee, Tae Yong Shin, Hyung Jun Moon, Hyun Jung Lee, Dongkil Jeong, Dongwook Lee, Sun In Hong, Hyun Joon Kim; J Korean Soc Clin Toxicol. 2023;21(2):135-142. Published online December 29, 2023; DOI: https://doi.org/10.22537/jksct.2023.00018

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Abstract PDF: Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status.
Methods
This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups.
Results
There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027–1.844), 1.017 (95% CI, 1.002–1.032), and 0.196 (95% CI, 0.040–0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746–0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652–0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527–0.722).
Conclusion
The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

2022 Annual Report of the Seoul Poison Control Center: Yo Han Shin, Sijin Lee, Su Jin Kim, Young Hoon Yoon, Sung Woo Lee, 서울시 독성물질 중독관리센터; J Korean Soc Clin Toxicol. 2023;21(1):39-55. Published online June 30, 2023; DOI: https://doi.org/10.22537/jksct.2023.00006

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Abstract PDF Supplementary Material

Purpose: The Korea University Anam Hospital Seoul Poison Control Center (SeoulPCC) was established in accordance with Seoul Metropolitan Government Ordinance No. 7524 “Seoul Metropolitan Government Ordinance on the Prevention of Toxic Substances Poisoning and Accident Safety.” Herein, the center’s annual performance in terms of project results and consultation information for 2022 are reported.
Methods
SeoulPCC operates a helpline (Help Call, 1855-2221) that the general public can use from 9:00 AM to 5:00 PM on weekdays, as well as chatting and chatbot counseling through KakaoTalk’s “Seoul Poison Control Center,” and one-on-one online counseling through the website. Additionally, it has constructed a system for communicating with the general public through social media. Poisoning disease information collected from SeoulPCC from January to December 2022 was analyzed according to the number of requests, age of exposure, gender, location, and reason. Requests from the general public were summarized, and a brief image presenting information on poisoning disease-related consultations was produced.
Results
SeoulPCC has a database containing information on 188,065 toxic substances collected by public institutions and provides this information to the general public and medical staff through its website. In 2022, consultations were performed through phone calls and SNS (social networking service) for 577 cases of poison information and first aid treatment due to exposure to toxic substances. There were 1,431 instances of providing poison information services. The annual requests included 512 exposure cases and 65 non-exposure cases. Furthermore, 366 cases were in Seoul, 145 cases were outside of Seoul, and 66 had an unknown location. The exposure cases included 161 requests from the general public and 351 requests from medical staff.
Conclusion
This is the first annual report in Korea to analyze the occurrence of poisoning based on consultations. It is of major significance that this report serves as a starting point for identifying and tracking the aspects and characteristics of poisoning cases in the pre-hospital stage. In the future, poisoning-related disease information provided through consultations and at the emergency room should be linked, and through real-time collection and analysis, this information should be used as basic data for poisoning disease management policies.

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Patterns of self-harm/suicide attempters who visited emergency department over the past 10 years and changes in poisoning as a major method (2011–2020)
Kyu Hyun Pai, Sung Woo Lee, Su Jin Kim, Kap Su Han, Juhyun Song, Sijin Lee, Ji Hwan Park, Jeijoon Song
Journal of The Korean Society of Clinical Toxicology.2023; 21(2): 69. CrossRef

Epidemiology of patients with snake bite or envenomation in emergency department: NEDIS (National Emergency Department Information System): Lee Serok, Jeon Woochan; J Korean Soc Clin Toxicol. 2022;20(2):45-50. Published online December 31, 2022; DOI: https://doi.org/10.22537/jksct.2022.20.2.45

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Abstract PDF: Purpose: This study utilizes the NEDIS (National Emergency Department Information System) database to suggest a predictive model for snakebite and envenomation in Korea by analyzing the geographical distribution and seasonal variation of snakebite patients visiting the ER. Methods: This was a retrospective study on snakebite patients visiting the ER using the NEDIS database from January 2014 to December 2019. The subjects include patients with the KCD (Korea Standard Classification of Disease) disease code T63.0 (Toxic effect of contact with snake venom). Geographical location, patient gender, patient age, date of ER visit, treatment during the ER stay, and disposition were recorded to analyze the geographical distribution and seasonal variation of snakebite patients in Korea. Results: A total of 12,521 patients were evaluated in this study (7,170 males, 54.9%; 5,351 females, 40.9%). The average age was 58.5±17.5 years. In all, 7,644 patients were admitted with an average admission time of 5.04±4.7 days, and 2 patients expired while admitted. The geographical distribution was Gyeongsang 3,370 (26.9%), Cheonra 2,692 (21.5%), Chungcheong 2,667 (21.3%), Seoul Capital area 1,999 (16.0%), Kangwon 1,457 (11.6%), and Jeju 336 (2.7%). The seasonal variation showed insignificant incidences in winter and higher severity in spring and summer than in fall: winter 27 (0.2%), spring 2,268 (18.1%), summer 6,847 (54.7%), and fall 3,380 (27.0%). Conclusion: Patients presenting with snakebites and envenomation in the emergency room were most common in the Gyeongsang area and during summer. The simple seasonal model predicted that 436 snakebites and 438 envenomation cases occurred in July and August. The results of this study can be applied to suitably distribute and stock antivenom. Appropriate policies can be formed to care for snakebite patients in Korea.

Comparative Analysis of decreased Mental state Patients after Overdose with Sedative-hypnotics: Seung Jae Oh, Soo Hyung Cho, So Yeon Ryu; J Korean Soc Clin Toxicol. 2022;20(1):8-14. Published online June 30, 2022; DOI: https://doi.org/10.22537/jksct.2022.20.1.8

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Abstract PDF: Purpose: This study was undertaken to investigate how sedative-hypnotics affect the occurrence and severity of the patient's symptoms. In addition, we conducted a study to determine the type of patients who reacted severely and required hospitalization; patients were accordingly classified as hospitalized patients and patients discharged from the emergency room. Methods: From January 2017 to December 2019, we investigated the demographics, drug information, history, laboratory tests, and severity of patients who visited our emergency department and were diagnosed with benzodiazepine, zolpidem, and doxylamine succinate overdose. We further compared details of hospitalized patients and discharged patients. Results: Subjects who had overdosed and visited the ED included 120 for benzodiazepine, 147 for zolpidem, and 27 for doxylamine succinate. Comparisons between the three groups revealed differences in their early diagnosis, psychiatric history, and sleep disturbance. Differences between groups were also determined for mental state, poisoning history, treatment received in the intensive care unit, and intubation and ventilator support. In cases of benzodiazepine overdose, we obtained a high hospitalization rate (40.0%), admission to the intensive care unit (24.2%), and intubation rate (18.3%). Comparisons between hospitalized patients and discharged groups showed differences in transferred patients, early diagnosis, and mental state. Conclusion: Patients poisoned by sedative-hypnotics are increasing every year. In cases of benzodiazepine and zolpidem, the hospitalization rates were high, and benzodiazepine overdose resulted in hospitalization, intensive care unit admission, and pneumonia in a majority of cases. Therefore, active treatment and quick decisions in the emergency room are greatly required.

Availability of urine toxicologic screening tests in the emergency department: focused on illegal drugs: Se Kyu Lee, Sangchun Choi; J Korean Soc Clin Toxicol. 2021;19(1):24-30. Published online June 30, 2021; DOI: https://doi.org/10.22537/jksct.2021.19.1.24

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Abstract PDF

Purpose: In Korea, it is predicted that the proportion of drug abusers among patients visiting the emergency room will soon increase. Several emergency medical institutions in Korea are conducting field urine screening tests for poisoning. In this study, we investigated the characteristics and usefulness of urine toxicology screening tests. Methods: The medical records of patients with positive results for tetrahydrocannabinol and methamphetamine from urine toxicology screening tests at a tertiary university hospital from August 2016 to August 2019 were reviewed retrospectively. The subjects were classified into positive and false-positive groups, and their clinical characteristics were compared and analyzed. Results: Of the 2,026 patients surveyed, 823 patients (40.6%) tested positive for one or more drugs. Among them, 12 cases (0.6%) were positive for methamphetamine and 40 cases (2.0%) were positive for tetrahydrocannabinol. The positive and the false-positive rates for methamphetamine were 66.7% and 33.3%, respectively. The positive and the false-positive rates for tetrahydrocannabinol were 2.5% and 97.5%, respectively. Conclusion: Methamphetamine showed a relatively low false-positive rate in our study. Therefore, this test seemed to assist in diagnosing methamphetamine poisoning when considered together with the present illness and physical examination results. On the other hand, the high false-positive rate for tetrahydrocannabinol tests indicates that this test was unlikely to assist in diagnosing tetrahydrocannabinol poisoning. However, considering the growing trend of illegal drug abusers in Korea, it may still be useful as a diagnostic tool for identifying drug users.

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Retrospective Analysis Study of False-Positive Amphetamine Immunoassay Cases and Negative Cases after Withdrawal while Taking Herbal Medicine-Containing Ephedra Sinica Confirmed in a Korean Medicine Obesity Clinic
Byungsoo Kang, Suyong Shin, Jungsang Kim, Minwhee Kang, Donghoon Lee, Seonghyeon Jeon, Minwoo Bang
Journal of Korean Medicine for Obesity Research.2024; 24(1): 94. CrossRef

Systematic review for economic benefit of poison control center: Eunah Han, Hyuna Hwang, Gina Yu, Dong Ryul Ko, Taeyoung Kong, Je Sung You, Minhong Choa, Sung Phil Chung; J Korean Soc Clin Toxicol. 2021;19(1):1-7. Published online June 30, 2021; DOI: https://doi.org/10.22537/jksct.2021.19.1.1

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Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

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2022 Annual Report of the Seoul Poison Control Center
Yo Han Shin, Sijin Lee, Su Jin Kim, Young Hoon Yoon, Sung Woo Lee
Journal of The Korean Society of Clinical Toxicology.2023; 21(1): 39. CrossRef

Clinical and Epidemiological Characteristics of Severe Poisoning Patients and Analysis of Prognostic Factors: Young Yun Jung, Chul Min Ha, Sung Tae Jung, Hyoung Ju Lee; J Korean Soc Clin Toxicol. 2020;18(2):94-101. Published online December 31, 2020; DOI: https://doi.org/10.22537/jksct.2020.18.2.94

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Abstract PDF: Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.

Respiratory Failure following Tetramine poisoning after Ingestion of Sea Snail: A Case Report: Joo Hwan Lee, Jin Wook Park, Seong Jun Hong, Jae-Cheon Jeon, Sang-Chan Jin; J Korean Soc Clin Toxicol. 2020;18(1):42-46. Published online June 30, 2020; DOI: https://doi.org/10.22537/jksct.2020.18.1.42

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Abstract PDF: Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5℃, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO2 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO3- 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

A Case of Green Tobacco Sickness (GTS) in Elderly Patient: Dong Kil Jeong, Doh-Eui Kim; J Korean Soc Clin Toxicol. 2019;17(2):132-134. Published online December 31, 2019; DOI: https://doi.org/10.22537/jksct.2019.17.2.132

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Abstract PDF: Green tobacco sickness is an illness caused by dermal exposure to nicotine. The common symptoms of the disease include dizziness, headache, nausea, vomiting, severe general weakness, fluctuations of blood pressure or heartbeat, abdominal cramping, chills, increased sweating, salivation, and difficulty breathing. A 79-year-old female arrived at the emergency room for an evaluation of sudden onset dizziness. Magnetic resonance imaging and angiography of the brain did not show any relevant abnormal findings. Four days later, with supportive care, she said that she had harvested green tobacco for six hours on the day of admission and the tobacco harvest was the first time in her life. She sweated excessively during the hot and humid weather and the tobacco leaves were wet from rain the night before. The serum cotinine tested at five days of admission was 16ng/ml. She was diagnosed with acute nicotine poisoning by her clinical symptoms and the half-life of cotinine in the blood.

A Case of Zaltoprofen Induced Kounis Syndrome: Seong You Lee, Won Young Sung, Jang Young Lee, Sang Won Seo, Won Suk Lee; J Korean Soc Clin Toxicol. 2019;17(1):32-37. Published online June 30, 2019; DOI: https://doi.org/10.22537/jksct.2019.17.1.32

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Abstract PDF: Kounis syndrome is defined as the occurrence of acute coronary syndrome associated with vasoactive mediators, such as histamines in the setting of hypersensitivity and allergic reactions or anaphylactic insults. The condition can be caused by various drugs, foods, or environmental factors that cause allergic reactions. A 35-year-old male visited the emergency room with anaphylaxis accompanied by chest pain approximately 20 minutes after taking zaltoprofen, a nonsteroidal anti-inflammatory drug. After acute treatment for the anaphylaxis, the patient was stabilized and all symptoms disappeared, but the ischemic changes in the electrocardiogram and elevation of the cardiac enzymes were observed. The emergency cardiac angiography and echocardiography were all normal. The allergic reaction of this patient to zaltoprofen was believed to cause a temporary coronary arterial vasospasm, inducing Type 1 Kounis syndrome. Thus far, there have been case reports of Kounis syndrome caused by a range of nonsteroidal anti-inflammatory drugs, but there are no reports of the condition being caused by zaltoprofen. According to the pathophysiology, both cardiac and allergic symptoms must be solved simultaneously, so rapid treatment and diagnosis are needed. Doctors treating acute allergic reactions and anaphylaxis patients must check the cardiovascular symptoms thoroughly and consider the possibility of Kounis syndrome.

Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy for Treatment of Calcium Channel Blockers, Angiotensin II Receptor Blockers, and Metformin Overdose: Jae Han Jeong, Kyung Hoon Sun, Yong Jin Park, Sun Pyo Kim; J Korean Soc Clin Toxicol. 2018;16(2):165-171. Published online December 31, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.2.165

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Abstract PDF: An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.

Changes in Toxicological Characteristics after Sales of Nonprescription Drugs in Convenience Stores: Chang Yeong Kim, Eui Jung Lee, Sung Woo Lee, Su Jin Kim, Kap Su Han; J Korean Soc Clin Toxicol. 2018;16(1):42-48. Published online June 30, 2018; DOI: https://doi.org/10.22537/jksct.2018.16.1.42

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Abstract PDF: Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

Comparison of Epidemiology and Outcomes of Patients with Intentional Poisoning by Age Groups: Single Center Observation Study: Jin Hyun Kim, Jin Seong Cho, Jin Joo Kim, Yong Su Lim, Hyuk Jun Yang, Geun Lee; J Korean Soc Clin Toxicol. 2016;14(2):129-135. Published online December 31, 2016; DOI: https://doi.org/10.22537/jksct.2016.14.2.129

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Purpose: This study was conducted to compare demographic and characteristic differences in self-poisoned patients by age groups using a comprehensive trauma database. Methods: This study included 1,823 patients who were admitted to the emergency room following self-poisoning. Three age groups were defined: young patients (less than 19 years), adult patients (19 to 64 years) and elderly patients (65 years and old). From January 2011 to December 2015, data were obtained from in a single emergency medical center. We investigated the materials of poisoning, ingestion time, GCS, systolic blood pressure, heart rate, and outcomes of patients. Results: A total of 1,823 self-poisoned patients visited the hospital during 5 years. Among these, 130 (7.1%) were categorized as young, 1,460 (80.1%) were adults and 233 (12.8%) were elderly. The most common drug of self-poisoning substances was antipyretics (50.0%) for those in the young group, sedative drugs (45.0%) for adults, and pesticides (41.2%) for the elderly. Mortality was 2.7% in the adult group and 14.6% in the elderly group. After adjusting for all factors related to mortality, the odds ratio (OR) of mortality was 2.63 in the elderly group (95% confidence interval [CI]: 1.44-4.81). Conclusion: There were definite differences in the characteristics of three groups. The younger patients used drugs that could be easily obtained while older patients used more lethal drugs.

Citations

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Factors Associated with Mortality in Elderly Patients Admitted to Intensive Care Unit due to Acute Drug Intoxication from Suicide Attempts
Kyung-Eun Kim, Sun-Hee Moon, Chieun Song, Minjeong An
Journal of Korean Critical Care Nursing.2024; 17(2): 1. CrossRef
Clinical features of adolescents with suicide attempt and the factors associated with their outcomes: poisoning versus non-poisoning
Myoung Hoon Lee, Jae Ho Jang, Jin-Seong Cho, Woo Sung Choi, Jea Yeon Choi
Pediatric Emergency Medicine Journal.2020; 7(2): 85. CrossRef

Limitation of Psychiatric Intervention for Suicidal Drug Intoxication Patients in Emergency Room: Joo Hwan Lee, Seung Jun Yang, Seung Wan Eun, Sang Chan Jin, Woo Ik Choi, Sung Won Jung; J Korean Soc Clin Toxicol. 2016;14(1):37-46. Published online June 30, 2016

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Abstract PDF: Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

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