Thomas Reydel1, Jean-Christophe Callahan2, Laurent Verley3, Christelle Teiten4, Christophe Andreotti5, Yann Erick Claessens6, David Missud7, Erwan L'Her4, Gael Le Roux8, Nicolas Lerolle9. 1. Angers University, Angers, France; Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France. 2. Department of Emergency Medicine, Le Mans Hospital, Le Mans, France. 3. Department of Emergency Medicine, Saint Malo Hospital, Saint Malo, France. 4. Department of Emergency Medicine, Brest University Hospital, Brest, France. 5. Department of Emergency Medicine, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. 6. Department of Emergency Medicine, Centre Hospitalier Princesse Grace, Principauté de, Monaco. 7. Clinical Research Center, Angers University Hospital, Angers, France. 8. Poison Center, Angers University Hospital, Angers, France. 9. Angers University, Angers, France; Department of Medical Intensive Care and Hyperbaric Medicine, Angers University Hospital, Angers, France. Electronic address: nicolas.lerolle@univ-angers.fr.
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.
CONTEXT: Routine biological tests are frequently ordered in self-poisoningpatients, 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-poisoningpatients 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-poisoningpatients. Abnormal results are frequent but their relevance at bedside remains limited.