ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2015
Clinical risk factors for in-hospital adverse cardiovascular events after acute drug overdose.
Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 36 citations in OpenAlex.
- Clinical Factors Associated With Ventricular Dysrhythmia in Emergency Department Patients With Severe QTc Prolongation After Drug Overdose.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Development of a risk-prediction nomogram for in-hospital adverse cardiovascular events in acute cardiotoxic agents poisoning.Toxicology reports · 2024Article
- Predicting adverse cardiovascular events in emergency department patients with bupropion overdose.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2024Article
- Serum copeptin, lactate, and shock index as predictors of morbidity and mortality in shocked acutely poisoned patients.Toxicology research · 2024Article
- Early vs. delayed QTc prolongation in acute poisoning: A prognostic accuracy study-A case series.PloS one · 2024Article
- Validation of Corrected and Dispersed QT as Predictors of Adverse Outcomes in Acute Cardiotoxicities.Cardiovascular toxicology · 2022Article
- Prior use of medications for opioid use disorder in ED patients with opioid overdose: prevalence, misuse and overdose severity.The American journal of emergency medicine · 2022Observational
- Delayed QT Prolongation: Derivation of a Novel Risk Factor for Adverse Cardiovascular Events from Acute Drug Overdose.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2021Article
- Biomarkers of endothelial dysfunction in cocaine overdose and overdose-related cardiovascular events.Addiction biology · 2021Article
- First-Line Vasopressor and Mortality Rates in ED Patients with Acute Drug Overdose.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2021Observational
- Antidotal Sodium Bicarbonate Therapy: Delayed QTc Prolongation and Cardiovascular Events.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2021Observational
- Drug-specific risk of severe QT prolongation following acute drug overdose.Clinical toxicology (Philadelphia, Pa.) · 2020Article
- Management of pharmaceutical and recreational drug poisoning.Annals of intensive care · 2020Review
- Clinical predictors of adverse cardiovascular events for acute pediatric drug exposures.Clinical toxicology (Philadelphia, Pa.) · 2020Article
- Incidence and risk factors for hyperlactatemia in ED patients with acute metformin overdose.The American journal of emergency medicine · 2019Observational
- Article
- Prognostic Utility of Initial Lactate in Patients With Acute Drug Overdose: A Validation Cohort.Annals of emergency medicine · 2018Observational
- Risk factors for severe respiratory depression from prescription opioid overdose.Addiction (Abingdon, England) · 2018Article
- Acute salicylate poisoning: risk factors for severe outcome.Clinical toxicology (Philadelphia, Pa.) · 2017Article
- Validation of the Prognostic Utility of the Electrocardiogram for Acute Drug Overdose.Journal of the American Heart Association · 2017Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesIt was recently demonstrated that adverse cardiovascular events (ACVE) complicate a high proportion of hospitalizations for patients with acute drug overdoses. The aim of this study was to derive independent clinical risk factors for ACVE in patients with acute drug overdoses.
methodsThis prospective cohort study was conducted over 3 years at two urban university hospitals. Patients were adults with acute drug overdoses enrolled from the ED. In-hospital ACVE was defined as any of myocardial injury, shock, ventricular dysrhythmia, or cardiac arrest.
resultsThere were 1,562 patients meeting inclusion/exclusion criteria (mean age, 41.8 years; female, 46%; suicidal, 38%). ACVE occurred in 82 (5.7%) patients (myocardial injury, 61; shock, 37; dysrhythmia, 23; cardiac arrests, 22) and there were 18 (1.2%) deaths. On univariate analysis, ACVE risk increased with age, lower serum bicarbonate, prolonged QTc interval, prior cardiac disease, and altered mental status. In a multivariable model adjusting for these factors as well as patient sex and hospital site, independent predictors were: QTc > 500 msec (3.8% prevalence, odds ratio [OR] = 27.6), bicarbonate < 20 mEq/L (5.4% prevalence, OR = 4.4), and prior cardiac disease (7.1% prevalence, OR = 9.5). The derived prediction rule had 51.6% sensitivity, 93.7% specificity, and 97.1% negative predictive value, while presence of two or more risk factors had 90.9% positive predictive value.
conclusionsThe authors derived independent clinical risk factors for ACVE in patients with acute drug overdose, which should be validated in future studies as a prediction rule in distinct patient populations and clinical settings.
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