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HOME > J Korean Soc Clin Toxicol > Volume 19(1); 2021 > Article
Comparison of Poisoning Severity Score (PSS) according to alcohol co-ingestion in intentional poisoning patients
Min jae Jun, Tae kyu Ahn, Soo Kang
Journal of The Korean Society of Clinical Toxicology 2021;19(1):17-23
DOI: https://doi.org/10.22537/jksct.2021.19.1.17
Published online: June 30, 2021
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1Department of Emergency Medicine, Inha University School of Medicine
2Department of Emergency Medicine, Inha University School of Medicine
3Department of Emergency Medicine, Inha University School of Medicine

Purpose: Alcohol ingestion enhances impulsivity and aggression, and has been proven to have a close relationship with suicide. This study investigates whether alcohol co-ingestion affects the Poisoning Severity Score (PSS) grade in patients with intentional poisoning. Methods: We conducted a retrospective analysis of intentional poisoning patients who visited the emergency department (ED) from January 1 to December 31, 2020. Patients were divided into non-drunken and drunken groups. We collected the data based on the medical records of the patients and serum ethanol level results recorded during initial blood tests at the ED. To grade the PSS, the highest score was assessed through clinical signs and test results during the hospital stay. A comparative analysis was conducted between the two groups. Results: A total of 277 patients were included in the study. 163 (58.8%) were in the non-drunken group, and 114 (41.2%) were in the drunken group. The PSS grade showed a significant difference between the two groups (p=0.002). While grade 1 (mild) was observed more in the non-drunken group, grade 2 (moderate) and grade 3 (severe) were seen more in the drunken group. In an ordinal logistic regression analysis, alcohol co-ingestion (adjusted odds ratio [aOR] 2.557, 95% confidence interval [CI] 1.554-4.208, p<0.001) was considered to be a risk factor for a higher PSS grade. There was no significant correlation between the serum ethanol level and the PSS grade. (p=0.568) Conclusion: Intentional poisoning patients with alcohol co-ingestion had a higher PSS. Hence close observation and aggressive treatment in the ED is warranted in such cases.


JKSCT : Journal of The Korean Society of Clinical Toxicology