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Routine biological tests in self-poisoning patients: results from an observational prospective multicenter study - 25/07/16

Doi : 10.1016/j.ajem.2016.04.002 
Thomas Reydel, MD a, b, Jean-Christophe Callahan, MD c, Laurent Verley, MD d, Christelle Teiten, MD e, Christophe Andreotti, MD f, Yann Erick Claessens, MD, PhD g, David Missud, MD h, Erwan L'Her, MD, PhD e, Gael Le Roux, MD i, Nicolas Lerolle, MD, PhD a, b,
a Angers University, Angers, France 
b Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France 
c Department of Emergency Medicine, Le Mans Hospital, Le Mans, France 
d Department of Emergency Medicine, Saint Malo Hospital, Saint Malo, France 
e Department of Emergency Medicine, Brest University Hospital, Brest, France 
f Department of Emergency Medicine, Cochin University Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France 
g Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Principauté de, Monaco 
h Clinical Research Center, Angers University Hospital, Angers, France 
i Poison Center, Angers University Hospital, Angers, France 

Corresponding author at: Département de Réanimation Médicale et de Médecine Hyperbare, Centre Hospitalier Universitaire, 4 rue Larrey, F-49 933 Angers Cedex 9, France.Département de Réanimation Médicale et de Médecine HyperbareCentre Hospitalier Universitaire4 rue Larrey, F-49 933 Angers Cedex 9France

Abstract

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.

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Esquema


 This work was financially supported by institutional funding: Angers University, Angers and Angers University Hospital, Angers, France.
☆☆ All authors declare no conflict of interest.
 The work was performed in 5 French centers: Angers University Hospital, Brest University Hospital, Cochin University Hospital (Paris), Le Mans Hospital, and Saint Malo Hospital, France.


© 2016  Elsevier Inc. Reservados todos los derechos.
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Vol 34 - N° 8

P. 1383-1388 - août 2016 Regresar al número
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