Department of medical intensive care and hyperbaric medicine, Angers University Hospital, Angers, France
Correspondence
Corresponding author at: Département de Réanimation Médicale et de Médecine Hyperbare, Centre Hospitalier Universitaire, 4 rue Larrey, F-49 933 Angers, Cedex 9, France.
Department of medical intensive care and hyperbaric medicine, Angers University Hospital, Angers, France
Correspondence
Corresponding author at: Département de Réanimation Médicale et de Médecine Hyperbare, Centre Hospitalier Universitaire, 4 rue Larrey, F-49 933 Angers, Cedex 9, France.
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Abstract
Context
Routine biological tests are frequently ordered in self-poisoning patients, but their clinical relevance is poorly studied.
Material and methods
Prospective multicentric observational study, Emergency departments and intensive care units in five university and non-university 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. 1027 patients were enrolled (age 40.2 ± 14 years, women 61.5%), no patient died during the hospital stay. Benzodiazepine were suspected in >70% of cases; 65% (range 48% - 80%) of patients had at least one routine biological test performed. At least one abnormal test was registered in 23% of these patients. Three factors were associated with abnormal test results: age> 40 years, male sex, and poisoning with a drug known to alter routine tests (i.e. 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, three patients were referred to the intensive care unit solely because of abnormal test results.
Conclusion
Routine biological tests are commonly prescribed in non-severe self-poisoning patients. Abnormal results are frequent but their relevance at bedside remains limited.
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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 five french center: Angers University Hospital, Brest University Hospital, Cochin University Hospital (Paris), Le Mans Hospital and Saint Malo Hospital, France.
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