Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients

Abstract Aim Prescription drug and over‐the‐counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care among overdose patients. Methods T...

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Main Authors: Chie Tanaka, Takashi Tagami, Makihiko Nagano, Fumihiko Nakayama, Junya Kaneko, Masamune Kuno
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Acute Medicine & Surgery
Subjects:
Online Access:https://doi.org/10.1002/ams2.942
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author Chie Tanaka
Takashi Tagami
Makihiko Nagano
Fumihiko Nakayama
Junya Kaneko
Masamune Kuno
author_facet Chie Tanaka
Takashi Tagami
Makihiko Nagano
Fumihiko Nakayama
Junya Kaneko
Masamune Kuno
author_sort Chie Tanaka
collection DOAJ
description Abstract Aim Prescription drug and over‐the‐counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care among overdose patients. Methods This was a single‐center retrospective cohort study. We included overdoses patients of prescription drugs or OTC drugs, who admitted to our hospital between 2016 and 2021. We grouped them into advanced care and non‐advanced care. The main outcome was the need for advanced care. We performed a multiple logistic regression analysis, calculated the PAV score (Paracetamol use, Alcohol use, abnormal Vital signs on scene) and performed a receiver operating characteristic (ROC) analysis. Results There were 229 subjects. The logistic regression analysis revealed that alcohol, paracetamol, and the abnormal vital signs on scene were associated with advanced care (alcohol‐odds ratio [OR]: 2.95; 95% confidence interval [CI]: 1.29–6.75; paracetamol‐OR: 5.47; 95% CI: 2.18–13.71; abnormal vital signs‐OR: 4.61, 95% CI: 2.07–10.27). The rate of advanced care in the high PAV score (2 and 3) group was statistically higher than that in the low PAV score (0–1) group (p = 0.04). Area under the ROC curve of the PAV score was 0.72 (95% CI, 0.65–0.80). Conclusion Alcohol, paracetamol use and abnormal vital signs on scene might be risk factors for advanced care among prescription drugs or OTC drugs overdose patients, and the PAV score may predict the need for advanced care.
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spelling doaj-art-1d5d4d4a80e449dc9f2e4f08f47a39372024-12-30T10:18:37ZengWileyAcute Medicine & Surgery2052-88172024-01-01111n/an/a10.1002/ams2.942Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patientsChie Tanaka0Takashi Tagami1Makihiko Nagano2Fumihiko Nakayama3Junya Kaneko4Masamune Kuno5Department of Emergency and Critical Care Medicine Nippon Medical School Tama Nagayama Hospital Tama‐shi JapanDepartment of Emergency and Critical Care Medicine Nippon Medical School Musashikosugi Hospital Kawasaki JapanDepartment of Pharmacy Nippon Medical School Tama City JapanDepartment of Emergency and Critical Care Medicine Nippon Medical School Tama Nagayama Hospital Tama‐shi JapanDepartment of Emergency and Critical Care Medicine Nippon Medical School Tama Nagayama Hospital Tama‐shi JapanDepartment of Emergency and Critical Care Medicine Nippon Medical School Tama Nagayama Hospital Tama‐shi JapanAbstract Aim Prescription drug and over‐the‐counter (OTC) drug overdose is a major problem in emergency departments in Japan, and some need advanced care which is more than observation. We aimed to identify the prehospital risk factors for the need of advanced care among overdose patients. Methods This was a single‐center retrospective cohort study. We included overdoses patients of prescription drugs or OTC drugs, who admitted to our hospital between 2016 and 2021. We grouped them into advanced care and non‐advanced care. The main outcome was the need for advanced care. We performed a multiple logistic regression analysis, calculated the PAV score (Paracetamol use, Alcohol use, abnormal Vital signs on scene) and performed a receiver operating characteristic (ROC) analysis. Results There were 229 subjects. The logistic regression analysis revealed that alcohol, paracetamol, and the abnormal vital signs on scene were associated with advanced care (alcohol‐odds ratio [OR]: 2.95; 95% confidence interval [CI]: 1.29–6.75; paracetamol‐OR: 5.47; 95% CI: 2.18–13.71; abnormal vital signs‐OR: 4.61, 95% CI: 2.07–10.27). The rate of advanced care in the high PAV score (2 and 3) group was statistically higher than that in the low PAV score (0–1) group (p = 0.04). Area under the ROC curve of the PAV score was 0.72 (95% CI, 0.65–0.80). Conclusion Alcohol, paracetamol use and abnormal vital signs on scene might be risk factors for advanced care among prescription drugs or OTC drugs overdose patients, and the PAV score may predict the need for advanced care.https://doi.org/10.1002/ams2.942acetaminophenadvanced carealcoholoverdoseparacetamol
spellingShingle Chie Tanaka
Takashi Tagami
Makihiko Nagano
Fumihiko Nakayama
Junya Kaneko
Masamune Kuno
Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
Acute Medicine & Surgery
acetaminophen
advanced care
alcohol
overdose
paracetamol
title Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
title_full Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
title_fullStr Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
title_full_unstemmed Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
title_short Risk factors for the need for advanced care among prescription and over‐the‐counter drug overdose patients
title_sort risk factors for the need for advanced care among prescription and over the counter drug overdose patients
topic acetaminophen
advanced care
alcohol
overdose
paracetamol
url https://doi.org/10.1002/ams2.942
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