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Bita Dadpour , Zahra Hatami , Amirreza Liaghat , Ali Eshraghi , Fares Najari , Dorsa Najari ,
Volume 77, Issue 7 (October 2019)
Abstract

Background: QT dispersion means the difference between the minimum and maximum QT interval in a standard twelve standard electrocardiogram, which indicates ventricular repolarization and electrical instability of the heart. In this study, we try to find a link between methadone poisoning and the change in QT dispersion, so that we can accurately assess the patient's condition and medical needs in the future.
Methods: In a descriptive, randomized/ cross-sectional study in the poisoning ward of Imam Reza Hospital in Mashhad from October 2013 to April 2015, all patients who referred to the emergency department because of their methadone toxicity or symptoms, had an ECG with 12 leads taken from them, at the time of the arrival. QT dispersion was calculated manually in comparison to other parameters. Also their blood sample were taken to the lab in order to measure different electrolytes (Mg, K, Ca). To ensure the accuracy of study, patient’s urine samples were taken and tested for methadone. There was no intervention in this study. The control group was also not considered QT scattering and dispersion was compared with normal reference in this study.
Results: In this study, 100 patients were studied, 65 of them males (65%) and 35 females (35%). Mean age of subjects entering the study was 33.87±14.5. The average dose of methadone in these cases was 35.5±35.7 mg. However, their usual dose was 1.11±4.85 mg prior to overdoses, and the average duration of use mentioned in patients who had a history of usage was 5.1 months, but 90% of the subjects did not mention any history. The average measured potassium was 3.99±0.5 meq/l, calcium was 8.94±0.5 meq/l, and magnesium was 1.98±0.26 mg/dl. Average measured oxygen saturation at the time of admission was 94.43±5.6%. Mean QT dispersion was 0.041±0.018 millisecond.
Conclusion: In our study, no significant correlation was found between QT dispersion and methadone poisoning.

Majid Khadem-Rezaiyan, Fares Najari, Bita Dadpour,
Volume 78, Issue 8 (November 2020)
Abstract

Background: Opioid poisoning is the most common type of poisoning in intensive care units (ICUs). This group usually includes patients who have been drug abusers for a long time and now require hospitalization either because of acute overdose or due to side effects of routine opioid use. This study aimed to compare the severity and prognosis of patients using common mortality predictors Sequential Organ Failure Assessment (SOFA), Simplified Acute Physiology Score (SAPS II), Acute Physiology And Chronic Health Evaluation (APACHE II, APACHE IV) on different days of hospitalization.
Methods: This cross-sectional study was performed on all patients with opioid poisoning admitted to the ICU, Imam Reza Hospital, Mashhad, Iran, from the beginning of April 2016 to March 2017 (Persian Calendar). For all poisoned patients enrolled in the study, the four mortality predicting tools were filled daily in the first three days of hospitalization and then every other day until discharge from the ICU or patient's death.
Results: Overall, 57 patients were evaluated of whom 72% (41 patients) were male. The mean age was 49.9±19.8 (median 53, range 18-94) years. The mean length of stay in the ICU was 13.5±17.5 (median 7, range: 75-75) days. The mortality rate was 17.5% (10 patients). The scores of SOFA, SAPS II, APACHE II, and APACHE IV were significantly higher in deceased patients than in discharged ones. The highest diagnostic accuracy (area under the curve) for all four predicting tools was observed in the second week of hospitalization. On the other hand, SAPS II (74%) on the first day, APACHE-II (76%) on the second day, APACHE-II (82%) on the third day, SOFA (77%) on day 4-5, and SAPS II (82%) on day 6-7 had the highest diagnostic accuracy.
Conclusion: In the present study scores of all four mortality predicting tools at admission were significantly associated with mortality. The accuracy of SAPS II, APACHE IV, and APACHE II are appropriate for estimating prognosis, especially after the second week of admission.


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