Lyfjaeitranir á bráðamóttöku Borgarspítalans á sex mánaða tímabili 1983-1984

Abstract

A prospective study of acute self poisonings admitted to the Reykjavik City Hospital emergency ward is presented in this paper. The study period was 6 months from December 1983 through May 1984. 145 patients were admitted, 74 females and 71 males. The largest age group was 20-29 years (30%) and 67% of the patients were less than 40 years of age. A drug screening and alchohol assays were performed in 104 cases on admission, and a drug history was obtained in all possible instances. 93 blood samples were positive for drugs and/or alchohol and 24 different drugs were found. Bensodiazepines were by far the most common compounds (52%) and antidepressants came in second (18%). Cannabinoids were found in 3 cases, but they were not routinely looked for. Multiple drugs and a combination of drugs and alchohol were common. A comparison of drug assays and drug history revealed that discrepancies between the purported drug consumption and toxicological results were frequent. A complete agreement was only found in 43% and a partial agreement in 14% of the cases. Most of the poisonings were relatively mild, requiring only short hospitalization. There was one death from hydrochloric acid poisoning.

Borgarspítalinn hefur nokkra sérstöðu meðal sjúkrahúsanna í Reykjavik vegna slysadeildarinnar, sem er einasta bráðamóttakan á höfuðborgarsvæðinu. Þangað koma flestir þeir sem þurfa á læknismeðferð eða rannsókn að halda vegna lyfjaeitrana eða gruns um eitranir. Þegar hafa verið gerðar tvær rannsóknir á sjúklingum sem innlagðir voru á lyflækningadeild Borgarspítalans vegna lyfjaeitrana árin 1971-1975 (1) og 1976-1981 (2). Rannsókn sú, sem hér greinir frá, er frábrugðin hinum fyrri að því leyti, að hún er framsýn (prospektiv) og nær til allra sjúklinga, sem komu á slysadeild Borgarspítalans á 6 mánaða tímabili vegna gruns um eitrun. Stuðst var við lyfjamælingar í mun fleiri tilfellum en áður og rannsóknin gefur því miklu nákvæmari mynd af hlutdeild einstakra lyfja og eiturefna en fyrri athuganir, sem styðjast að mestu leyti við lyfjasögu.