J 2023

Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis

VIRMANI, Ishita, Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER et. al.

Základní údaje

Originální název

Accuracy of substance exposure history in patients attending emergency departments after substance misuse; a comparison with biological sample analysis

Autoři

VIRMANI, Ishita (356 Indie, garant, domácí), Alberto OTEO, Michael DUNN, Daniel VIDLER, Clair ROPER, Jane OFFICER, Gareth HARDY, Paul I. DARGAN, Michael EDDLESTON, Jamie G. COOPER, Simon L. HILL, Rebecca MACFARLANE, Liza KEATING, Mark HADEN, Simon HUDSON a Simon H. L. THOMAS

Vydání

Clinical Toxicology, Abingdon, Taylor & Francis, 2023, 1556-3650

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30108 Toxicology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 3.300 v roce 2022

Kód RIV

RIV/00216224:14310/23:00130510

Organizační jednotka

Přírodovědecká fakulta

UT WoS

000878056700001

Klíčová slova anglicky

Substance use; accuracy; self-reported

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 4. 4. 2024 16:28, Mgr. Marie Šípková, DiS.

Anotace

V originále

Context Acute toxicity caused by illicit substance use is a common reason for emergency department (ED) presentation. Knowledge of the substances involved is helpful for predicting and managing potential toxicity, but limited information is available about the accuracy of patient-reported substance exposure. This study assessed the accuracy of the history of exposure in those reporting use of a single substance by comparison with those identified by detailed toxicological analysis, focusing on synthetic cannabinoid receptor agonists (SCRA). Methods Adults (>= 16 years) presenting between March 2015 and July 2021 to participating UK hospitals with toxicity after reporting use of a single illicit substance were included. Exposure details were documented from medical records and blood and/or urine samples analysed using high-resolution accurate mass liquid chromatography-mass spectrometry (HRAM LCMS). Sensitivity, specificity, and positive and negative predictive values of the exposure history were calculated by comparison with biological sample analysis ("gold standard"). Results Single substance exposure was reported for 474 (median age 33 years, IQR: 18 range 16-75, 80% males) patients. Analysis commonly identified multiple substances (Median 3, IQR 2-5). A history of exposure was documented for 121 of 151 patients where a SCRA or metabolite was detected on analysis (sensitivity 80.1%, 95% CI 72.9, 86.2%). Corresponding proportions were lower for 3,4-methylenedioxymethamphetamine (MDMA, 44/70, 62.9%., 95% CI 50.5%, 74.1%), heroin 41/108 (38.0% 95% CI 28.8-47.8%) and cocaine (22/56, 31.3%, 95% CI 20.9, 43.6%). Conclusions Multiple undeclared substances were detected analytically in most patients reporting single substance use. Clinicians should be alert to the potential presence and toxicity of unreported substances when managing patients presenting after substance misuse.

Návaznosti

EF17_043/0009632, projekt VaV
Název: CETOCOEN Excellence
90121, velká výzkumná infrastruktura
Název: RECETOX RI