ArticleJournal of the American Heart Association2017
Validation of the Prognostic Utility of the Electrocardiogram for Acute Drug Overdose.
Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 34 citations in OpenAlex.
- A Flexible Wearable Electronics System for Electrocardiographic Assessment of Colchicine Therapy for Post-MI Remodeling.Sensors (Basel, Switzerland) · 2026Article
- 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
- Assessment of B-type natriuretic peptide as an early predictor of mortality in acutely poisoned patients with cardiotoxicities.Toxicology research · 2024Article
- Early vs. delayed QTc prolongation in acute poisoning: A prognostic accuracy study-A case series.PloS one · 2024Article
- Macrophage Migration Inhibitory Factor as a Potential Biomarker in Acetaminophen Overdose: A Pilot Study.Toxicology communications · 2022Article
- Safety of ibogaine administration in detoxification of opioid-dependent individuals: a descriptive open-label observational study.Addiction (Abingdon, England) · 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
- 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
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWhile it is certain that some emergency department patients with acute drug overdose suffer adverse cardiovascular events (ACVE), predicting ACVE is difficult. The prognostic utility of the ECG for heterogeneous drug overdose patients remains to be proven. This study was undertaken to validate previously derived features of the initial ECG associated with ACVE in this population. METHODS AND
resultsWe performed a prospective validation cohort study to evaluate adult emergency department patients with acute drug overdose at 2 urban university hospitals over 5 years in whom an emergency department admission ECG was performed. Exclusion criteria were alternate diagnoses, anaphylaxis, chronic drug toxicity, and missing outcome data. ACVE was defined as any of the following: circulatory shock, myocardial injury, ventricular dysrhythmia, or cardiac arrest. Blinded cardiologists interpreted ECGs for previously derived predictors of ACVE (ectopy, QT prolongation, nonsinus rhythm, ischemia/infarction), QT dispersion, and prominent R wave in lead AVR. Of 589 patients who met inclusion criteria (48% male, mean age 42), there were 95 ACVEs (39 shock, 64 myocardial injury, 26 dysrhythmia, 16 cardiac arrest). The most common drug exposures were as follows: benzodiazepines, opioids, and acetaminophen. Previously derived criteria were highly predictive of ACVE, with QT correction >500 ms as the highest risk feature (OR 11.2, CI 4.6-27).
conclusionsThis study confirms that early ECG evaluation is essential to assess the cardiovascular prognosis and medical clearance of emergency department patients with acute drug overdose. Furthermore, this study validates previously derived high-risk features of the admission ECG to risk stratify for ACVE in this patient population.
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