Is there a relationship between admission blood glucose level following acute poisoning and clinical outcome?

Abstract

IntroductionThe aim of this study was to investigate the relationship between the admission blood glucose level following acute poisoning, severity of acute poisoning and clinical outcome.Material and methodsThis prospective study was conducted on 345 deliberate self-poisoning patients. Standard demographic and clinical information; admission blood glucose level; poisoning severity score and outcome were recorded. Patients with a history of diabetes mellitus, receipt of pre-sampling intravenous dextrose solution or glucocorticoids, and poisoning with toxic agents which produce hyper- or hypoglycaemia were excluded.ResultsMean age of the patients was 27.5 ±8.6 years. Females outnumbered males (57.9%). Oral ingestion of more than one drug (46.7%) and opiates (14.2%) were the main causes of poisoning. Blood glucose values ranged from 50 mg/dl to 396 mg/dl. Hyper- and hypoglycaemia were observed in 23.8% and 13.91% respectively. A total of 24.41% and 22.92% of the patients in hyper- and hypoglycaemic groups had grade 3 and 4 severity score in comparison with 4.18% in the normoglycaemic group. Development of complications and death were 14.64% and 10.42% in patients with hyper- and hypoglycaemia versus 3.73% in patients with normoglycaemia. A significant difference between normoglycaemic and hyperglycaemic patients in the severity of poisoning and clinical outcome was observed (P < 0.001).ConclusionsAdmission blood glucose levels may have a relationship with the severity of poisoning and clinical outcome following acute poisoning.

Development and validation of a risk-prediction nomogram for in-hospital mortality in adults poisoned with drugs and nonpharmaceutical agents

“…[36] The association between glucose levels and mortality in patients with organophosphate and methanol poisoning has been proven. [37,38] We did not include glucose levels in the nomogram, based on the results of multivariate analysis.…”

Biosensors for Blood Glucose and Diabetes Diagnosis: Evolution, Construction, and Current Status

“…The type of drug determines whether hyper-or hypo-glycemia occurs (Sabzghabaee et al 2011;Pohanka, Románek, and Pikula 2012). Long-term hyperglycemia may be involved in many life-threatening complications such as cardiovascular diseases, diabetic nephropathy, neuropathy, and rethinopathy.…”

Validation of the Poisoning Severity Score (PSS) in suicidal behavior by self‐poisoning

“…It is critical to quantify the medical severity of SBSP in suicide attempt cases. First, accurate assessment of the medical severity of SBSP informs medical treatment, including guiding decisions about admission, level of care, and length of stay (Cevik, Unluoglu, Yanturali, Kalkan, & Sahin, 2006;Sabzghabaee, Eizadi-Mood, Gheshlaghi, Adib, & Safaeian, 2011). Second, patients who make more medically severe suicide attempts are at higher risk for eventual suicide than those who make suicide attempts of lower medical severity (Beautrais, 2004;Hawton & Fagg, 1988;Ostamo & Lonnqvist, 2001), underscoring the importance of vigilance with these patients.…”

“…Importantly, because it takes into consideration all major organ systems in scoring, it is capable of assessing a broad range of poisoning effects, making it optimal for widespread use including in medico-legal cases. Following its introduction and initial testing, evidence for the validity of the PSS has been based on studies of calls to Poison Centers (Bentur, Raikhlin-Eisenkraft, & Lavee, 2004;Casey, Dexter, Michell, & Vale, 1998;Wong, Taylor, Ashby, & Robinson, 2010) and poisoning patients presenting to hospital (Peter et al, 2013;Sabzghabaee et al, 2011;Thanacoody et al, 2016). This research has shown that the PSS predicts clinical outcomes including mortality (Peter et al, 2013;Sabzghabaee et al, 2011;Thanacoody et al, 2016) and that it is correlated with other validated measures of acute medical morbidity (Akdur et al, 2010;Churi, Ramesh, Bhakta, & Chris, 2012;Peter et al, 2013;Sam et al, 2009).…”

“…Following its introduction and initial testing, evidence for the validity of the PSS has been based on studies of calls to Poison Centers (Bentur, Raikhlin-Eisenkraft, & Lavee, 2004;Casey, Dexter, Michell, & Vale, 1998;Wong, Taylor, Ashby, & Robinson, 2010) and poisoning patients presenting to hospital (Peter et al, 2013;Sabzghabaee et al, 2011;Thanacoody et al, 2016). This research has shown that the PSS predicts clinical outcomes including mortality (Peter et al, 2013;Sabzghabaee et al, 2011;Thanacoody et al, 2016) and that it is correlated with other validated measures of acute medical morbidity (Akdur et al, 2010;Churi, Ramesh, Bhakta, & Chris, 2012;Peter et al, 2013;Sam et al, 2009). A major limitation of this evidence is that it is based primarily on studies of single drug exposures including organophosphate (Akdur et al, 2010;Peter et al, 2013;Sam et al, 2009), carbon monoxide (Cevik et al, 2006), and methanol or ethylene glycol (Thanacoody et al, 2016).…”